Surgical dissectors and manufacturing techniques

ABSTRACT

A surgical instrument comprising an end effector is disclosed. The end effector comprises a surgical dissector.

CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional application claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 62/578,793,entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE, filed Oct. 30, 2017,of U.S. Provisional Patent Application Ser. No. 62/578,804, entitledSURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENTTYPES OF END EFFECTOR MOVEMENT, filed Oct. 30, 2017, of U.S. ProvisionalPatent Application Ser. No. 62/578,817, entitled SURGICAL INSTRUMENTWITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS,filed Oct. 30, 2017, of U.S. Provisional Patent Application Ser. No.62/578,835, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELYACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed Oct. 30, 2017, of U.S.Provisional Patent Application Ser. No. 62/578,844, entitled SURGICALINSTRUMENT WITH MODULAR POWER SOURCES, filed Oct. 30, 2017, and of U.S.Provisional Patent Application Ser. No. 62/578,855, entitled SURGICALINSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed Oct. 30, 2017, thedisclosures of which are incorporated by reference herein in theirentirety. This non-provisional application claims the benefit under 35U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No.62/665,129, entitled SURGICAL SUTURING SYSTEMS, filed May 1, 2018, ofU.S. Provisional Patent Application Ser. No. 62/665,139, entitledSURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS, filed May 1, 2018, ofU.S. Provisional Patent Application Ser. No. 62/665,177, entitledSURGICAL INSTRUMENTS COMPRISING HANDLE ARRANGEMENTS, filed May 1, 2018,of U.S. Provisional Patent Application Ser. No. 62/665,128, entitledMODULAR SURGICAL INSTRUMENTS, filed May 1, 2018, of U.S. ProvisionalPatent Application Ser. No. 62/665,192, entitled SURGICAL DISSECTORS,filed May 1, 2018, and of U.S. Provisional Patent Application Ser. No.62/665,134, entitled SURGICAL CLIP APPLIER, filed May 1, 2018, thedisclosures of which are incorporated by reference herein in theirentirety.

BACKGROUND

The present invention relates to surgical systems and, in variousarrangements, to grasping instruments that are designed to grasp thetissue of a patient, dissecting instruments configured to manipulate thetissue of a patient, clip appliers configured to clip the tissue of apatient, and suturing instruments configured to suture the tissue of apatient, among others.

BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows:

FIG. 1 illustrates a surgical system comprising a handle and severalshaft assemblies—each of which are selectively attachable to the handlein accordance with at least one embodiment;

FIG. 2 is an elevational view of the handle and one of the shaftassemblies of the surgical system of FIG. 1;

FIG. 3 is a partial cross-sectional perspective view of the shaftassembly of FIG. 2;

FIG. 4 is another partial cross-sectional perspective view of the shaftassembly of FIG. 2;

FIG. 5 is a partial exploded view of the shaft assembly of FIG. 2;

FIG. 6 is a partial cross-sectional elevational view of the shaftassembly of FIG. 2;

FIG. 7 is an elevational view of a drive module of the handle of FIG. 1;

FIG. 8 is a cross-sectional perspective view of the drive module of FIG.7;

FIG. 9 is an end view of the drive module of FIG. 7;

FIG. 10 is a partial cross-sectional view of the interconnection betweenthe handle and shaft assembly of FIG. 2 in a locked configuration;

FIG. 11 is a partial cross-sectional view of the interconnection betweenthe handle and shaft assembly of FIG. 2 in an unlocked configuration;

FIG. 12 is a cross-sectional perspective view of a motor and a speedreduction gear assembly of the drive module of FIG. 7;

FIG. 13 is an end view of the speed reduction gear assembly of FIG. 12;

FIG. 14 is a partial perspective view of an end effector of the shaftassembly of FIG. 2 in an open configuration;

FIG. 15 is a partial perspective view of the end effector of FIG. 14 ina closed configuration;

FIG. 16 is a partial perspective view of the end effector of FIG. 14articulated in a first direction;

FIG. 17 is a partial perspective view of the end effector of FIG. 14articulated in a second direction;

FIG. 18 is a partial perspective view of the end effector of FIG. 14rotated in a first direction;

FIG. 19 is a partial perspective view of the end effector of FIG. 14rotated in a second direction;

FIG. 20 is a partial cross-sectional perspective view of the endeffector of FIG. 14 detached from the shaft assembly of FIG. 2;

FIG. 21 is an exploded view of the end effector of FIG. 14 illustratedwith some components removed;

FIG. 22 is an exploded view of a distal attachment portion of the shaftassembly of FIG. 2;

FIG. 22A is an exploded view of the distal portion of the shaft assemblyof FIG. 2 illustrated with some components removed;

FIG. 23 is another partial cross-sectional perspective view of the endeffector of FIG. 14 detached from the shaft assembly of FIG. 2;

FIG. 24 is a partial cross-sectional perspective view of the endeffector of FIG. 14 attached to the shaft assembly of FIG. 2;

FIG. 25 is a partial cross-sectional perspective view of the endeffector of FIG. 14 attached to the shaft assembly of FIG. 2;

FIG. 26 is another partial cross-sectional perspective view of the endeffector of FIG. 14 attached to the shaft assembly of FIG. 2;

FIG. 27 is a partial cross-sectional view of the end effector of FIG. 14attached to the shaft assembly of FIG. 2 depicting a first, second, andthird clutch of the end effector;

FIG. 28 depicts the first clutch of FIG. 27 in an unactuated condition;

FIG. 29 depicts the first clutch of FIG. 27 in an actuated condition;

FIG. 30 depicts the second clutch of FIG. 27 in an unactuated condition;

FIG. 31 depicts the second clutch of FIG. 27 in an actuated condition;

FIG. 32 depicts the third clutch of FIG. 27 in an unactuated condition;

FIG. 33 depicts the third clutch of FIG. 27 in an actuated condition;

FIG. 34 depicts the second and third clutches of FIG. 27 in theirunactuated conditions and the end effector of FIG. 14 locked to theshaft assembly of FIG. 2;

FIG. 35 depicts the second clutch of FIG. 27 in its unactuated conditionand the third clutch of FIG. 27 in its actuated condition;

FIG. 36 depicts the second and third clutches of FIG. 27 in theiractuated conditions and the end effector of FIG. 14 unlocked from theshaft assembly of FIG. 2;

FIG. 37 is a partial cross-sectional view of a shaft assembly inaccordance with at least one alternative embodiment comprising sensorsconfigured to detect the conditions of the first, second, and thirdclutches of FIG. 27;

FIG. 38 is a partial cross-sectional view of a shaft assembly inaccordance with at least one alternative embodiment comprising sensorsconfigured to detect the conditions of the first, second, and thirdclutches of FIG. 27;

FIG. 39 depicts the first and second clutches of FIG. 38 in theirunactuated conditions and a sensor in accordance with at least onealternative embodiment;

FIG. 40 depicts the second and third clutches of FIG. 38 in theirunactuated conditions and a sensor in accordance with at least onealternative embodiment;

FIG. 41 is a partial cross-sectional view of a shaft assembly inaccordance with at least one embodiment;

FIG. 42 is a partial cross-sectional view of the shaft assembly of FIG.41 comprising a clutch illustrated in an unactuated condition;

FIG. 43 is a partial cross-sectional view of the shaft assembly of FIG.41 illustrating the clutch in an actuated condition;

FIG. 44 is a partial cross-sectional view of a shaft assembly inaccordance with at least one embodiment comprising first and secondclutches illustrated in an unactuated condition;

FIG. 45 is a perspective view of the handle drive module of FIG. 7 andone of the shaft assemblies of the surgical system of FIG. 1;

FIG. 46 is another perspective view of the handle drive module of FIG. 7and the shaft assembly of FIG. 45;

FIG. 47 is a partial cross-sectional view of the shaft assembly of FIG.45 attached to the handle of FIG. 1;

FIG. 48 is another partial cross-sectional view of the shaft assembly ofFIG. 45 attached to the handle of FIG. 1;

FIG. 49 is a partial cross-sectional perspective view of the shaftassembly of FIG. 45;

FIG. 50 is a schematic of the control system of the surgical system ofFIG. 1.

FIG. 51 is an elevational view of a handle in accordance with at leastone embodiment and one of the shaft assemblies of the surgical system ofFIG. 1;

FIG. 52A is a partial top view of a drive module of the handle of FIG.51 illustrated in a first rotation configuration;

FIG. 52B is a partial top view of the drive module of FIG. 52Aillustrated in a second rotation configuration;

FIG. 53A is a partial top view of the drive module of FIG. 52Aillustrated in a first articulation configuration;

FIG. 53B is a partial top view of the drive module of FIG. 52Aillustrated in a second articulation configuration;

FIG. 54 is a partial cross-sectional perspective view of a drive modulein accordance with at least one embodiment;

FIG. 55 is a partial perspective view of the drive module of FIG. 54illustrated with some components removed;

FIG. 56 is a partial cross-sectional view of the drive module of FIG. 54illustrating an eccentric drive in a disengaged condition;

FIG. 57 is a partial cross-sectional view of the drive module of FIG. 54illustrating the eccentric drive of FIG. 56 in an engaged condition;

FIG. 58 is a partial top plan view of an embodiment of a surgicalinstrument;

FIG. 59 is a partial side elevation view of an embodiment of a surgicalinstrument;

FIG. 60 is a partial top plan view of various possible configurations ofan embodiment of a surgical instrument;

FIG. 61 is a partial side elevation view of various possibleconfigurations of an embodiment of a surgical instrument;

FIG. 62 is a partial top plan view of an embodiment of a surgicalinstrument;

FIG. 63 is a partial side elevation view of an embodiment of thesurgical instrument depicted in FIG. 62;

FIG. 64 is a partial top plan view of an embodiment of a surgicalinstrument;

FIG. 65 is a partial top plan view of an embodiment of a surgicalinstrument;

FIG. 66 is a partial top plan view of an embodiment of a surgicalinstrument;

FIG. 67 is a partial top plan view of an embodiment of a surgicalinstrument;

FIG. 68 is a partial top plan view of an embodiment of a surgicalinstrument which depicts a manufacturing envelope from which an endeffector of the surgical instrument is created;

FIG. 69 is a partial side elevation view of an embodiment of thesurgical instrument depicted in FIG. 68;

FIG. 70 is a partial top plan view of an embodiment of a surgicalinstrument which depicts a manufacturing envelope from which an endeffector of the surgical instrument is created;

FIG. 71 is a partial side elevation view of an embodiment of thesurgical instrument depicted in FIG. 70 which depicts a manufacturingenvelope from which an end effector of the surgical instrument iscreated;

FIG. 72 is a top perspective view of a jaw of a surgical instrument;

FIG. 73 is a partial perspective view of the jaw depicted in FIG. 72;

FIG. 74 is a top plan view of the jaw depicted in FIG. 72;

FIG. 75 is a bottom perspective view of the jaw depicted in FIG. 72;

FIG. 76 is a top perspective view of a jaw of a surgical instrument;

FIG. 77 is a top plan view of the jaw depicted in FIG. 76;

FIG. 78 is a partial perspective view of the jaw depicted in FIG. 76;

FIG. 79 is a partial perspective view of a jaw of a surgical instrument;

FIG. 80 is a partial cross-sectional view of a surgical instrumentincluding a jaw assembly capable of grasping and dissection inaccordance with at least one embodiment;

FIG. 81 is a graph depicting the force, speed, and orientation of thejaw assembly of FIG. 80 in accordance with at least one embodiment;

FIG. 82 is a partial perspective view of bipolar forceps being used tocut tissue;

FIG. 83 is a perspective view of the bipolar forceps of FIG. 82;

FIG. 84 is a graph depicting the force and speed of the jaws of thebipolar forceps of FIG. 82 in accordance with at least one embodiment;and

FIG. 85 is another graph depicting the operation of the bipolar forcepsof FIG. 82 in accordance with at least one embodiment.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. patentapplications that were filed on Aug. 24, 2018 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 16/112,129, entitled SURGICAL        SUTURING INSTRUMENT CONFIGURED TO MANIPULATE TISSUE USING        MECHANICAL AND ELECTRICAL POWER, now U.S. Patent Application        Publication No. 2019/0125431;    -   U.S. patent application Ser. No. 16/112,155, entitled SURGICAL        SUTURING INSTRUMENT COMPRISING A CAPTURE WIDTH WHICH IS LARGER        THAN TROCAR DIAMETER, now U.S. Patent Application Publication        No. 2019/0125335;    -   U.S. patent application Ser. No. 16/112,168, entitled SURGICAL        SUTURING INSTRUMENT COMPRISING A NON-CIRCULAR NEEDLE, now U.S.        Patent Application Publication No. 2019/0125336;    -   U.S. patent application Ser. No. 16/112,180, entitled ELECTRICAL        POWER OUTPUT CONTROL BASED ON MECHANICAL FORCES, now U.S. Patent        Application Publication No. 2019/0125432;    -   U.S. patent application Ser. No. 16/112,193, entitled REACTIVE        ALGORITHM FOR SURGICAL SYSTEM, now U.S. Patent Application        Publication No. 2019/0125337;    -   U.S. patent application Ser. No. 16/112,099, entitled SURGICAL        INSTRUMENT COMPRISING AN ADAPTIVE ELECTRICAL SYSTEM, now U.S.        Patent Application Publication No. 2019/0125378;    -   U.S. patent application Ser. No. 16/112,112, entitled CONTROL        SYSTEM ARRANGEMENTS FOR A MODULAR SURGICAL INSTRUMENT, now U.S.        Patent Application Publication No. 2019/0125320;    -   U.S. patent application Ser. No. 16/112,119, entitled ADAPTIVE        CONTROL PROGRAMS FOR A SURGICAL SYSTEM COMPRISING MORE THAN ONE        TYPE OF CARTRIDGE, now U.S. Patent Application Publication No.        2019/0125338;    -   U.S. patent application Ser. No. 16/112,097, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING BATTERY ARRANGEMENTS, now U.S.        Patent Application Publication No. 2019/0125377;    -   U.S. patent application Ser. No. 16/112,109, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING HANDLE ARRANGEMENTS, now U.S.        Patent Application Publication No. 2019/0125388;    -   U.S. patent application Ser. No. 16/112,114, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING FEEDBACK MECHANISMS, now U.S.        Patent Application Publication No. 2019/0142449;    -   U.S. patent application Ser. No. 16/112,117, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING LOCKOUT MECHANISMS, now U.S.        Patent Application Publication No. 2019/0125476;    -   U.S. patent application Ser. No. 16/112,095, entitled SURGICAL        INSTRUMENTS COMPRISING A LOCKABLE END EFFECTOR SOCKET, now U.S.        Patent Application Publication No. 2019/0125387;    -   U.S. patent application Ser. No. 16/112,121, entitled SURGICAL        INSTRUMENTS COMPRISING A SHIFTING MECHANISM, now U.S. Patent        Application Publication No. 2019/0125389;    -   U.S. patent application Ser. No. 16/112,151, entitled SURGICAL        INSTRUMENTS COMPRISING A SYSTEM FOR ARTICULATION AND ROTATION        COMPENSATION, now U.S. Pat. No. 10,772,651;    -   U.S. patent application Ser. No. 16/112,154, entitled SURGICAL        INSTRUMENTS COMPRISING A BIASED SHIFTING MECHANISM, now U.S.        Patent Application Publication No. 2019/0125321;    -   U.S. patent application Ser. No. 16/112,226, entitled SURGICAL        INSTRUMENTS COMPRISING AN ARTICULATION DRIVE THAT PROVIDES FOR        HIGH ARTICULATION ANGLES, now U.S. Patent Application        Publication No. 2019/0125379;    -   U.S. patent application Ser. No. 16/112,098, entitled SURGICAL        DISSECTORS CONFIGURED TO APPLY MECHANICAL AND ELECTRICAL ENERGY,        now U.S. Patent Application Publication No. 2019/0125430;    -   U.S. patent application Ser. No. 16/112,237, entitled SURGICAL        CLIP APPLIER CONFIGURED TO STORE CLIPS IN A STORED STATE, now        U.S. Patent Application Publication No. 2019/0125347;    -   U.S. patent application Ser. No. 16/112,245, entitled SURGICAL        CLIP APPLIER COMPRISING AN EMPTY CLIP CARTRIDGE LOCKOUT, now        U.S. Patent Application Publication No. 2019/0125352;    -   U.S. patent application Ser. No. 16/112,249, entitled SURGICAL        CLIP APPLIER COMPRISING AN AUTOMATIC CLIP FEEDING SYSTEM, now        U.S. Patent Application Publication No. 2019/0125353;    -   U.S. patent application Ser. No. 16/112,253, entitled SURGICAL        CLIP APPLIER COMPRISING ADAPTIVE FIRING CONTROL, now U.S. Patent        Application Publication No. 2019/0125348; and    -   U.S. patent application Ser. No. 16/112,257, entitled SURGICAL        CLIP APPLIER COMPRISING ADAPTIVE CONTROL IN RESPONSE TO A STRAIN        GAUGE CIRCUIT, now U.S. Patent Application Publication No.        2019/0125354.

Applicant of the present application owns the following U.S. patentapplications that were filed on May 1, 2018 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. Provisional Patent Application Ser. No. 62/665,129,        entitled SURGICAL SUTURING SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/665,139,        entitled SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/665,177,        entitled SURGICAL INSTRUMENTS COMPRISING HANDLE ARRANGEMENTS;    -   U.S. Provisional Patent Application Ser. No. 62/665,128,        entitled MODULAR SURGICAL INSTRUMENTS;    -   U.S. Provisional Patent Application Ser. No. 62/665,192,        entitled SURGICAL DISSECTORS; and    -   U.S. Provisional Patent Application Ser. No. 62/665,134,        entitled SURGICAL CLIP APPLIER.

Applicant of the present application owns the following U.S. patentapplications that were filed on Feb. 28, 2018 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 15/908,021, entitled SURGICAL        INSTRUMENT WITH REMOTE RELEASE;    -   U.S. patent application Ser. No. 15/908,012, entitled SURGICAL        INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT        TYPES OF END EFFECTOR MOVEMENT;    -   U.S. patent application Ser. No. 15/908,040, entitled SURGICAL        INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END        EFFECTOR FUNCTIONS;    -   U.S. patent application Ser. No. 15/908,057, entitled SURGICAL        INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END        EFFECTOR FUNCTIONS;    -   U.S. patent application Ser. No. 15/908,058, entitled SURGICAL        INSTRUMENT WITH MODULAR POWER SOURCES; and    -   U.S. patent application Ser. No. 15/908,143, entitled SURGICAL        INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS.

Applicant of the present application owns the following U.S. patentapplications that were filed on Oct. 30, 2017 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. Provisional Patent Application Ser. No. 62/578,793,        entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE;    -   U.S. Provisional Patent Application Ser. No. 62/578,804,        entitled SURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO        EFFECT DIFFERENT TYPES OF END EFFECTOR MOVEMENT;    -   U.S. Provisional Patent Application Ser. No. 62/578,817,        entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY        ACTUATING MULTIPLE END EFFECTOR FUNCTIONS;    -   U.S. Provisional Patent Application Ser. No. 62/578,835,        entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY        ACTUATING MULTIPLE END EFFECTOR FUNCTIONS;    -   U.S. Provisional Patent Application Ser. No. 62/578,844,        entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES; and    -   U.S. Provisional Patent Application Ser. No. 62/578,855,        entitled SURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Dec. 28, 2017, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

U.S. Provisional Patent Application Ser. No. 62/611,341, entitledINTERACTIVE SURGICAL PLATFORM;

-   -   U.S. Provisional Patent Application Ser. No. 62/611,340,        entitled CLOUD-BASED MEDICAL ANALYTICS; and    -   U.S. Provisional Patent Application Ser. No. 62/611,339,        entitled ROBOT ASSISTED SURGICAL PLATFORM.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Mar. 28, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/649,302,        entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED        COMMUNICATION CAPABILITIES;    -   U.S. Provisional Patent Application Ser. No. 62/649,294,        entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS        AND CREATE ANONYMIZED RECORD;    -   U.S. Provisional Patent Application Ser. No. 62/649,300,        entitled SURGICAL HUB SITUATIONAL AWARENESS;    -   U.S. Provisional Patent Application Ser. No. 62/649,309,        entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN        OPERATING THEATER;    -   U.S. Provisional Patent Application Ser. No. 62/649,310,        entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,291,        entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO        DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;    -   U.S. Provisional Patent Application Ser. No. 62/649,296,        entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,333,        entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER;    -   U.S. Provisional Patent Application Ser. No. 62/649,327,        entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND        AUTHENTICATION TRENDS AND REACTIVE MEASURES;    -   U.S. Provisional Patent Application Ser. No. 62/649,315,        entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS        NETWORK;    -   U.S. Provisional Patent Application Ser. No. 62/649,313,        entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,320,        entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,307,        entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS; and    -   U.S. Provisional Patent Application Ser. No. 62/649,323,        entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,641, entitled        INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION        CAPABILITIES;    -   U.S. patent application Ser. No. 15/940,648, entitled        INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES        AND DATA CAPABILITIES;    -   U.S. patent application Ser. No. 15/940,656, entitled SURGICAL        HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM        DEVICES;    -   U.S. patent application Ser. No. 15/940,666, entitled SPATIAL        AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS;    -   U.S. patent application Ser. No. 15/940,670, entitled        COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES        BY INTELLIGENT SURGICAL HUBS;    -   U.S. patent application Ser. No. 15/940,677, entitled SURGICAL        HUB CONTROL ARRANGEMENTS;    -   U.S. patent application Ser. No. 15/940,632, entitled DATA        STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE        ANONYMIZED RECORD;    -   U.S. patent application Ser. No. 15/940,640, entitled        COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND        STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED        ANALYTICS SYSTEMS;    -   U.S. patent application Ser. No. 15/940,645, entitled SELF        DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT;    -   U.S. patent application Ser. No. 15/940,649, entitled DATA        PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN        OUTCOME;    -   U.S. patent application Ser. No. 15/940,654, entitled SURGICAL        HUB SITUATIONAL AWARENESS;    -   U.S. patent application Ser. No. 15/940,663, entitled SURGICAL        SYSTEM DISTRIBUTED PROCESSING;    -   U.S. patent application Ser. No. 15/940,668, entitled        AGGREGATION AND REPORTING OF SURGICAL HUB DATA;    -   U.S. patent application Ser. No. 15/940,671, entitled SURGICAL        HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;    -   U.S. patent application Ser. No. 15/940,686, entitled DISPLAY OF        ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE;    -   U.S. patent application Ser. No. 15/940,700, entitled STERILE        FIELD INTERACTIVE CONTROL DISPLAYS;    -   U.S. patent application Ser. No. 15/940,629, entitled COMPUTER        IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. patent application Ser. No. 15/940,704, entitled USE OF        LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE        PROPERTIES OF BACK SCATTERED LIGHT;    -   U.S. patent application Ser. No. 15/940,722, entitled        CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF        MONO-CHROMATIC LIGHT REFRACTIVITY; and    -   U.S. patent application Ser. No. 15/940,742, entitled DUAL CMOS        ARRAY IMAGING.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,636, entitled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. patent application Ser. No. 15/940,653, entitled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL HUBS;    -   U.S. patent application Ser. No. 15/940,660, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER;    -   U.S. patent application Ser. No. 15/940,679, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS        WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET;    -   U.S. patent application Ser. No. 15/940,694, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED        INDIVIDUALIZATION OF INSTRUMENT FUNCTION;    -   U.S. patent application Ser. No. 15/940,634, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION        TRENDS AND REACTIVE MEASURES;    -   U.S. patent application Ser. No. 15/940,706, entitled DATA        HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and    -   U.S. patent application Ser. No. 15/940,675, entitled CLOUD        INTERFACE FOR COUPLED SURGICAL DEVICES.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,627, entitled DRIVE        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,637, entitled        COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. patent application Ser. No. 15/940,642, entitled CONTROLS        FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,676, entitled AUTOMATIC        TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,680, entitled        CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,683, entitled        COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. patent application Ser. No. 15/940,690, entitled DISPLAY        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and    -   U.S. patent application Ser. No. 15/940,711, entitled SENSING        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Mar. 30, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/650,887,        entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES;    -   U.S. Provisional Patent Application Ser. No. 62/650,877,        entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS;    -   U.S. Provisional Patent Application Ser. No. 62/650,882,        entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL        PLATFORM; and    -   U.S. Provisional Patent Application Ser. No. 62/650,898,        entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY        ELEMENTS.

Applicant of the present application owns the following U.S. Provisionalpatent application, filed on Apr. 19, 2018, which is herein incorporatedby reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/659,900,        entitled METHOD OF HUB COMMUNICATION.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. Well-known operations, components, andelements have not been described in detail so as not to obscure theembodiments described in the specification. The reader will understandthat the embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”), and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes”, or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes”, or “contains” one or more features possesses thoseone or more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, thereader will readily appreciate that the various methods and devicesdisclosed herein can be used in numerous surgical procedures andapplications including, for example, in connection with open surgicalprocedures. As the present Detailed Description proceeds, the readerwill further appreciate that the various instruments disclosed hereincan be inserted into a body in any way, such as through a naturalorifice, through an incision or puncture hole formed in tissue, etc. Theworking portions or end effector portions of the instruments can beinserted directly into a patient's body or can be inserted through anaccess device that has a working channel through which the end effectorand elongate shaft of a surgical instrument can be advanced.

A surgical instrument, such as a grasper, for example, can comprise ahandle, a shaft extending from the handle, and an end effector extendingfrom the shaft. In various instances, the end effector comprises a firstjaw and a second jaw, wherein one or both of the jaws are movablerelative to the other to grasp the tissue of a patient. That said, anend effector of a surgical instrument can comprise any suitablearrangement and can perform any suitable function. For instance, an endeffector can comprise first and second jaws configured to dissect orseparate the tissue of a patient. Also, for instance, an end effectorcan be configured to suture and/or clip the tissue of a patient. Invarious instances, the end effector and/or shaft of the surgicalinstrument are configured to be inserted into a patient through atrocar, or cannula, and can have any suitable diameter, such asapproximately 5 mm, 8 mm, and/or 12 mm, for example. U.S. patentapplication Ser. No. 11/013,924, entitled TROCAR SEAL ASSEMBLY, now U.S.Pat. No. 7,371,227, is incorporated by reference in its entirety. Theshaft can define a longitudinal axis and at least a portion of the endeffector can be rotatable about the longitudinal axis. Moreover, thesurgical instrument can further comprise an articulation joint which canpermit at least a portion of the end effector to be articulated relativeto the shaft. In use, a clinician can rotate and/or articulate the endeffector in order to maneuver the end effector within the patient.

A surgical instrument system is depicted in FIG. 1. The surgicalinstrument system comprises a handle assembly 1000 which is selectivelyusable with a shaft assembly 2000, a shaft assembly 3000, a shaftassembly 4000, a shaft assembly 5000, and/or any other suitable shaftassembly. The shaft assembly 2000 is attached to the handle assembly1000 in FIG. 2 and the shaft assembly 4000 is attached to the handleassembly 1000 in FIG. 45. The shaft assembly 2000 comprises a proximalportion 2100, an elongate shaft 2200 extending from the proximal portion2100, a distal attachment portion 2400, and an articulation joint 2300rotatably connecting the distal attachment portion 2400 to the elongateshaft 2200. The shaft assembly 2000 further comprises a replaceable endeffector assembly 7000 attached to the distal attachment portion 2400.The replaceable end effector assembly 7000 comprises a jaw assembly 7100configured to be opened and closed to clamp and/or manipulate the tissueof a patient. In use, the end effector assembly 7000 can be articulatedabout the articulation joint 2300 and/or rotated relative to the distalattachment portion 2400 about a longitudinal axis to better position thejaw assembly 7100 within the patient, as described in greater detailfurther below.

Referring again to FIG. 1, the handle assembly 1000 comprises, amongother things, a drive module 1100. As described in greater detail below,the drive module 1100 comprises a distal mounting interface whichpermits a clinician to selectively attach one of the shaft assemblies2000, 3000, 4000, and 5000, for example, to the drive module 1100. Thus,each of the shaft assemblies 2000, 3000, 4000, and 5000 comprises anidentical, or an at least similar, proximal mounting interface which isconfigured to engage the distal mounting interface of the drive module1100. As also described in greater detail below, the mounting interfaceof the drive module 1100 mechanically secures and electrically couplesthe selected shaft assembly to the drive module 1100. The drive module1100 further comprises at least one electric motor, one or more controlsand/or displays, and a controller configured to operate the electricmotor—the rotational output of which is transmitted to a drive system ofthe shaft assembly attached to the drive module 1100. Moreover, thedrive module 1100 is usable with one ore more power modules, such aspower modules 1200 and 1300, for example, which are operably attachableto the drive module 1100 to supply power thereto.

Further to the above, referring again to FIGS. 1 and 2, the handle drivemodule 1100 comprises a housing 1110, a first module connector 1120, anda second module connector 1120′. The power module 1200 comprises ahousing 1210, a connector 1220, one or more release latches 1250, andone or more batteries 1230. The connector 1220 is configured to beengaged with the first module connector 1120 of the drive module 1100 inorder to attach the power module 1200 to the drive module 1100. Theconnector 1220 comprises one or more latches 1240 which mechanicallycouple and fixedly secure the housing 1210 of the power module 1200 tothe housing 1110 of the drive module 1100. The latches 1240 are movableinto disengaged positions when the release latches 1250 are depressed sothat the power module 1200 can be detached from the drive module 1100.The connector 1220 also comprises one or more electrical contacts whichplace the batteries 1230, and/or an electrical circuit including thebatteries 1230, in electrical communication with an electrical circuitin the drive module 1100.

Further to the above, referring again to FIGS. 1 and 2, the power module1300 comprises a housing 1310, a connector 1320, one or more releaselatches 1350, and one or more batteries 1330 (FIG. 47). The connector1320 is configured to be engaged with the second module connector 1120′of the drive module 1100 to attach the power module 1300 to the drivemodule 1100. The connector 1320 comprises one or more latches 1340 whichmechanically couple and fixedly secure the housing 1310 of the powermodule 1300 to the housing 1110 of the drive module 1100. The latches1340 are movable into disengaged positions when the release latches 1350are depressed so that the power module 1300 can be detached from thedrive module 1100. The connector 1320 also comprises one or moreelectrical contacts which place the batteries 1330 of the power module1300, and/or an electrical power circuit including the batteries 1330,in electrical communication with an electrical power circuit in thedrive module 1100.

Further to the above, the power module 1200, when attached to the drivemodule 1100, comprises a pistol grip which can allow a clinician to holdthe handle 1000 in a manner which places the drive module 1100 on top ofthe clinician's hand. The power module 1300, when attached to the drivemodule 1100, comprises an end grip which allows a clinician to hold thehandle 1000 like a wand. The power module 1200 is longer than the powermodule 1300, although the power modules 1200 and 1300 can comprise anysuitable length. The power module 1200 has more battery cells than thepower module 1300 and can suitably accommodate these additional batterycells owing to its length. In various instances, the power module 1200can provide more power to the drive module 1100 than the power module1300 while, in some instances, the power module 1200 can provide powerfor a longer period of time. In some instances, the housing 1110 of thedrive module 1100 comprises keys, and/or any other suitable features,which prevent the power module 1200 from being connected to the secondmodule connector 1120′ and, similarly, prevent the power module 1300from being connected to the first module connector 1120. Such anarrangement can assure that the longer power module 1200 is used in thepistol grip arrangement and that the shorter power module 1300 is usedin the wand grip arrangement. In alternative embodiments, the powermodule 1200 and the power module 1300 can be selectively coupled to thedrive module 1100 at either the first module connector 1120 or thesecond module connector 1120′. Such embodiments provide a clinician withmore options to customize the handle 1000 in a manner suitable to them.

In various instances, further to the above, only one of the powermodules 1200 and 1300 is coupled to the drive module 1100 at a time. Incertain instances, the power module 1200 can be in the way when theshaft assembly 4000, for example, is attached to the drive module 1100.Alternatively, both of the power modules 1200 and 1300 can be operablycoupled to the drive module 1100 at the same time. In such instances,the drive module 1100 can have access to power provided by both of thepower modules 1200 and 1300. Moreover, a clinician can switch between apistol grip and a wand grip when both of the power modules 1200 and 1300are attached to the drive module 1100. Moreover, such an arrangementallows the power module 1300 to act as a counterbalance to a shaftassembly, such as shaft assemblies 2000, 3000, 4000, or 5000, forexample, attached to the drive module 1100.

Referring to FIGS. 7 and 8, the handle drive module 1100 furthercomprises a frame 1500, a motor assembly 1600, a drive system 1700operably engaged with the motor assembly 1600, and a control system1800. The frame 1500 comprises an elongate shaft that extends throughthe motor assembly 1600. The elongate shaft comprises a distal end 1510and electrical contacts, or sockets, 1520 defined in the distal end1510. The electrical contacts 1520 are in electrical communication withthe control system 1800 of the drive module 1100 via one or moreelectrical circuits and are configured to convey signals and/or powerbetween the control system 1800 and the shaft assembly, such as theshaft assembly 2000, 3000, 4000, or 5000, for example, attached to thedrive module 1100. The control system 1800 comprises a printed circuitboard (PCB) 1810, at least one microprocessor 1820, and at least onememory device 1830. The board 1810 can be rigid and/or flexible and cancomprise any suitable number of layers. The microprocessor 1820 and thememory device 1830 are part of a control circuit defined on the board1810 which controls the operation of the motor assembly 1600, asdescribed in greater detail below.

Referring to FIGS. 12 and 13, the motor assembly 1600 comprises anelectric motor 1610 including a housing 1620, a drive shaft 1630, and agear reduction system. The electric motor 1610 further comprises astator including windings 1640 and a rotor including magnetic elements1650. The stator windings 1640 are supported in the housing 1620 and therotor magnetic elements 1650 are mounted to the drive shaft 1630. Whenthe stator windings 1640 are energized with an electric currentcontrolled by the control system 1800, the drive shaft 1630 is rotatedabout a longitudinal axis. The drive shaft 1630 is operably engaged witha first planetary gear system 1660 which includes a central sun gear andseveral planetary gears operably intermeshed with the sun gear. The sungear of the first planetary gear system 1660 is fixedly mounted to thedrive shaft 1630 such that it rotates with the drive shaft 1630. Theplanetary gears of the first planetary gear system 1660 are rotatablymounted to the sun gear of a second planetary gear system 1670 and,also, intermeshed with a geared or splined inner surface 1625 of themotor housing 1620. As a result of the above, the rotation of the firstsun gear rotates the first planetary gears which rotate the second sungear. Similar to the above, the second planetary gear system 1670further comprises planetary gears 1665 (FIG. 13) which drive a thirdplanetary gear system and, ultimately, the drive shaft 1710. Theplanetary gear systems 1660, 1670, and 1680 co-operate to gear down thespeed applied to the drive shaft 1710 by the motor shaft 1620. Variousalternative embodiments are envisioned without a speed reduction system.Such embodiments are suitable when it is desirable to drive the endeffector functions quickly. Notably, the drive shaft 1630 comprises anaperture, or hollow core, extending therethrough through which wiresand/or electrical circuits can extend.

The control system 1800 is in communication with the motor assembly 1600and the electrical power circuit of the drive module 1100. The controlsystem 1800 is configured to control the power delivered to the motorassembly 1600 from the electrical power circuit. The electrical powercircuit is configured to supply a constant, or at least nearly constant,direct current (DC) voltage. In at least one instance, the electricalpower circuit supplies 3 VDC to the control system 1800. The controlsystem 1800 comprises a pulse width modulation (PWM) circuit which isconfigured to deliver voltage pulses to the motor assembly 1600. Theduration or width of the voltage pulses, and/or the duration or widthbetween the voltage pulses, supplied by the PWM circuit can becontrolled in order to control the power applied to the motor assembly1600. By controlling the power applied to the motor assembly 1600, thePWM circuit can control the speed of the output shaft of the motorassembly 1600. In addition to or in lieu of a PWM circuit, the controlsystem 1800 can include a frequency modulation (FM) circuit. Asdiscussed in greater detail below, the control system 1800 is operablein more than one operating mode and, depending on the operating modebeing used, the control system 1800 can operate the motor assembly 1600at a speed, or a range of speeds, which is determined to be appropriatefor that operating mode.

Further to the above, referring again to FIGS. 7 and 8, the drive system1700 comprises a rotatable shaft 1710 comprising a splined distal end1720 and a longitudinal aperture 1730 defined therein. The rotatableshaft 1710 is operably mounted to the output shaft of the motor assembly1600 such that the rotatable shaft 1710 rotates with the motor outputshaft. The handle frame 1510 extends through the longitudinal aperture1730 and rotatably supports the rotatable shaft 1710. As a result, thehandle frame 1510 serves as a bearing for the rotatable shaft 1710. Thehandle frame 1510 and the rotatable shaft 1710 extend distally from amounting interface 1130 of the drive module 1110 and are coupled withcorresponding components on the shaft assembly 2000 when the shaftassembly 2000 is assembled to the drive module 1100. Referring primarilyto FIGS. 3-6, the shaft assembly 2000 further comprises a frame 2500 anda drive system 2700. The frame 2500 comprises a longitudinal shaft 2510extending through the shaft assembly 2000 and a plurality of electricalcontacts, or pins, 2520 extending proximally from the shaft 2510. Whenthe shaft assembly 2000 is attached to the drive module 1100, theelectrical contacts 2520 on the shaft frame 2510 engage the electricalcontacts 1520 on the handle frame 1510 and create electrical pathwaystherebetween.

Similar to the above, the drive system 2700 comprises a rotatable driveshaft 2710 which is operably coupled to the rotatable drive shaft 1710of the handle 1000 when the shaft assembly 2000 is assembled to thedrive module 1100 such that the drive shaft 2710 rotates with the driveshaft 1710. To this end, the drive shaft 2710 comprises a splinedproximal end 2720 which mates with the splined distal end 1720 of thedrive shaft 1710 such that the drive shafts 1710 and 2710 rotatetogether when the drive shaft 1710 is rotated by the motor assembly1600. Given the nature of the splined interconnection between the driveshafts 1710 and 2710 and the electrical interconnection between theframes 1510 and 2510, the shaft assembly 2000 is assembled to the handle1000 along a longitudinal axis; however, the operable interconnectionbetween the drive shafts 1710 and 2710 and the electricalinterconnection between the frames 1510 and 2510 can comprise anysuitable configuration which can allow a shaft assembly to be assembledto the handle 1000 in any suitable manner.

As discussed above, referring to FIGS. 3-8, the mounting interface 1130of the drive module 1110 is configured to be coupled to a correspondingmounting interface on the shaft assemblies 2000, 3000, 4000, and 5000,for example. For instance, the shaft assembly 2000 comprises a mountinginterface 2130 configured to be coupled to the mounting interface 1130of the drive module 1100. More specifically, the proximal portion 2100of the shaft assembly 2000 comprises a housing 2110 which defines themounting interface 2130. Referring primarily to FIG. 8, the drive module1100 comprises latches 1140 which are configured to releasably hold themounting interface 2130 of the shaft assembly 2000 against the mountinginterface 1130 of the drive module 1100. When the drive module 1100 andthe shaft assembly 2000 are brought together along a longitudinal axis,as described above, the latches 1140 contact the mounting interface 2130and rotate outwardly into an unlocked position. Referring primarily toFIGS. 8, 10, and 11, each latch 1140 comprises a lock end 1142 and apivot portion 1144. The pivot portion 1144 of each latch 1140 isrotatably coupled to the housing 1110 of the drive module 1100 and, whenthe latches 1140 are rotated outwardly, as mentioned above, the latches1140 rotate about the pivot portions 1144. Notably, each latch 1140further comprises a biasing spring 1146 configured to bias the latches1140 inwardly into a locked position. Each biasing spring 1146 iscompressed between a latch 1140 and the housing 1110 of the drive module1100 such that the biasing springs 1146 apply biasing forces to thelatches 1140; however, such biasing forces are overcome when the latches1140 are rotated outwardly into their unlocked positions by the shaftassembly 2000. That said, when the latches 1140 rotate outwardly aftercontacting the mounting interface 2130, the lock ends 1142 of thelatches 1140 can enter into latch windows 2140 defined in the mountinginterface 2130. Once the lock ends 1142 pass through the latch windows2140, the springs 1146 can bias the latches 1140 back into their lockedpositions. Each lock end 1142 comprises a lock shoulder, or surface,which securely holds the shaft assembly 2000 to the drive module 1100.

Further to the above, the biasing springs 1146 hold the latches 1140 intheir locked positions. The distal ends 1142 are sized and configured toprevent, or at least inhibit, relative longitudinal movement, i.e.,translation along a longitudinal axis, between the shaft assembly 2000and the drive module 1100 when the latches 1140 are in their lockedpositions. Moreover, the latches 1140 and the latch windows 1240 aresized and configured to prevent relative lateral movement, i.e.,translation transverse to the longitudinal axis, between the shaftassembly 2000 and the drive module 1100. In addition, the latches 1140and the latch windows 2140 are sized and configured to prevent the shaftassembly 2000 from rotating relative to the drive module 1100. The drivemodule 1100 further comprises release actuators 1150 which, whendepressed by a clinician, move the latches 1140 from their lockedpositions into their unlocked positions. The drive module 1100 comprisesa first release actuator 1150 slideably mounted in an opening defined inthe first side of the handle housing 1110 and a second release actuator1150 slideably mounted in an opening defined in a second, or opposite,side of the handle housing 1110. Although the release actuators 1150 areactuatable separately, both release actuators 1150 typically need to bedepressed to completely unlock the shaft assembly 2000 from the drivemodule 1100 and allow the shaft assembly 2000 to be detached from thedrive module 1100. That said, it is possible that the shaft assembly2000 could be detached from the drive module 1100 by depressing only onerelease actuator 1150.

Once the shaft assembly 2000 has been secured to the handle 1000 and theend effector 7000, for example, has been assembled to the shaft 2000,the clinician can maneuver the handle 1000 to insert the end effector7000 into a patient. In at least one instance, the end effector 7000 isinserted into the patient through a trocar and then manipulated in orderto position the jaw assembly 7100 of the end effector assembly 7000relative to the patient's tissue. Oftentimes, the jaw assembly 7100 mustbe in its closed, or clamped, configuration in order to fit through thetrocar. Once through the trocar, the jaw assembly 7100 can be opened sothat the patient tissue fit between the jaws of the jaw assembly 7100.At such point, the jaw assembly 7100 can be returned to its closedconfiguration to clamp the patient tissue between the jaws. The clampingforce applied to the patient tissue by the jaw assembly 7100 issufficient to move or otherwise manipulate the tissue during a surgicalprocedure. Thereafter, the jaw assembly 7100 can be re-opened to releasethe patient tissue from the end effector 7000. This process can berepeated until it is desirable to remove the end effector 7000 from thepatient. At such point, the jaw assembly 7100 can be returned to itsclosed configuration and retracted through the trocar. Other surgicaltechniques are envisioned in which the end effector 7000 is insertedinto a patient through an open incision, or without the use of thetrocar. In any event, it is envisioned that the jaw assembly 7100 mayhave to be opened and closed several times throughout a surgicaltechnique.

Referring again to FIGS. 3-6, the shaft assembly 2000 further comprisesa clamping trigger system 2600 and a control system 2800. The clampingtrigger system 2600 comprises a clamping trigger 2610 rotatablyconnected to the proximal housing 2110 of the shaft assembly 2000. Asdiscussed below, the clamping trigger 2610 actuates the motor 1610 tooperate the jaw drive of the end effector 7000 when the clamping trigger2610 is actuated. The clamping trigger 2610 comprises an elongateportion which is graspable by the clinician while holding the handle1000. The clamping trigger 2610 further comprises a mounting portion2620 which is pivotably connected to a mounting portion 2120 of theproximal housing 2110 such that the clamping trigger 2610 is rotatableabout a fixed, or an at least substantially fixed, axis. The closuretrigger 2610 is rotatable between a distal position and a proximalposition, wherein the proximal position of the closure trigger 2610 iscloser to the pistol grip of the handle 1000 than the distal position.The closure trigger 2610 further comprises a tab 2615 extendingtherefrom which rotates within the proximal housing 2110. When theclosure trigger 2610 is in its distal position, the tab 2615 ispositioned above, but not in contact with, a switch 2115 mounted on theproximal housing 2110. The switch 2115 is part of an electrical circuitconfigured to detect the actuation of the closure trigger 2610 which isin an open condition the closure trigger 2610 is in its open position.When the closure trigger 2610 is moved into its proximal position, thetab 2615 comes into contact with the switch 2115 and closes theelectrical circuit. In various instances, the switch 2115 can comprise atoggle switch, for example, which is mechanically switched between openand closed states when contacted by the tab 2615 of the closure trigger2610. In certain instances, the switch 2115 can comprise a proximitysensor, for example, and/or any suitable type of sensor. In at least oneinstance, the switch 2115 comprises a Hall Effect sensor which candetect the amount in which the closure trigger 2610 has been rotatedand, based on the amount of rotation, control the speed in which themotor 1610 is operated. In such instances, larger rotations of theclosure trigger 2610 result in faster speeds of the motor 1610 whilesmaller rotations result in slower speeds, for example. In any event,the electrical circuit is in communication with the control system 2800of the shaft assembly 2000, which is discussed in greater detail below.

Further to the above, the control system 2800 of the shaft assembly 2000comprises a printed circuit board (PCB) 2810, at least onemicroprocessor 2820, and at least one memory device 2830. The board 2810can be rigid and/or flexible and can comprise any suitable number oflayers. The microprocessor 2820 and the memory device 2830 are part of acontrol circuit defined on the board 2810 which communicates with thecontrol system 1800 of the handle 1000. The shaft assembly 2000 furthercomprises a signal communication system 2900 and the handle 1000 furthercomprises a signal communication system 1900 which are configured toconvey data between the shaft control system 2800 and the handle controlsystem 1800. The signal communication system 2900 is configured totransmit data to the signal communication system 1900 utilizing anysuitable analog and/or digital components. In various instances, thecommunication systems 2900 and 1900 can communicate using a plurality ofdiscrete channels which allows the input gates of the microprocessor1820 to be directly controlled, at least in part, by the output gates ofthe microprocessor 2820. In some instances, the communication systems2900 and 1900 can utilize multiplexing. In at least one such instance,the control system 2900 includes a multiplexing device that sendsmultiple signals on a carrier channel at the same time in the form of asingle, complex signal to a multiplexing device of the control system1900 that recovers the separate signals from the complex signal.

The communication system 2900 comprises an electrical connector 2910mounted to the circuit board 2810. The electrical connector 2910comprises a connector body and a plurality of electrically-conductivecontacts mounted to the connector body. The electrically-conductivecontacts comprise male pins, for example, which are soldered toelectrical traces defined in the circuit board 2810. In other instances,the male pins can be in communication with circuit board traces throughzero-insertion-force (ZIF) sockets, for example. The communicationsystem 1900 comprises an electrical connector 1910 mounted to thecircuit board 1810. The electrical connector 1910 comprises a connectorbody and a plurality of electrically-conductive contacts mounted to theconnector body. The electrically-conductive contacts comprise femalepins, for example, which are soldered to electrical traces defined inthe circuit board 1810. In other instances, the female pins can be incommunication with circuit board traces through zero-insertion-force(ZIF) sockets, for example. When the shaft assembly 2000 is assembled tothe drive module 1100, the electrical connector 2910 is operably coupledto the electrical connector 1910 such that the electrical contacts formelectrical pathways therebetween. The above being said, the connectors1910 and 2910 can comprise any suitable electrical contacts. Moreover,the communication systems 1900 and 2900 can communicate with one anotherin any suitable manner. In various instances, the communication systems1900 and 2900 communicate wirelessly. In at least one such instance, thecommunication system 2900 comprises a wireless signal transmitter andthe communication system 1900 comprises a wireless signal receiver suchthat the shaft assembly 2000 can wirelessly communicate data to thehandle 1000. Likewise, the communication system 1900 can comprise awireless signal transmitter and the communication system 2900 cancomprise a wireless signal receiver such that the handle 1000 canwirelessly communicate data to the shaft assembly 2000.

As discussed above, the control system 1800 of the handle 1000 is incommunication with, and is configured to control, the electrical powercircuit of the handle 1000. The handle control system 1800 is alsopowered by the electrical power circuit of the handle 1000. The handlecommunication system 1900 is in signal communication with the handlecontrol system 1800 and is also powered by the electrical power circuitof the handle 1000. The handle communication system 1900 is powered bythe handle electrical power circuit via the handle control system 1800,but could be directly powered by the electrical power circuit. As alsodiscussed above, the handle communication system 1900 is in signalcommunication with the shaft communication system 2900. That said, theshaft communication system 2900 is also powered by the handle electricalpower circuit via the handle communication system 1900. To this end, theelectrical connectors 1910 and 2010 connect both one or more signalcircuits and one or more power circuits between the handle 1000 and theshaft assembly 2000. Moreover, the shaft communication system 2900 is insignal communication with the shaft control system 2800, as discussedabove, and is also configured to supply power to the shaft controlsystem 2800. Thus, the control systems 1800 and 2800 and thecommunication systems 1900 and 2900 are all powered by the electricalpower circuit of the handle 1000; however, alternative embodiments areenvisioned in which the shaft assembly 2000 comprises its own powersource, such as one or more batteries, for example, an and electricalpower circuit configured to supply power from the batteries to thehandle systems 2800 and 2900. In at least one such embodiment, thehandle control system 1800 and the handle communication system 1900 arepowered by the handle electrical power system and the shaft controlsystem 2800 and the handle communication system 2900 are powered by theshaft electrical power system.

Further to the above, the actuation of the clamping trigger 2610 isdetected by the shaft control system 2800 and communicated to the handlecontrol system 1800 via the communication systems 2900 and 1900. Uponreceiving a signal that the clamping trigger 2610 has been actuated, thehandle control system 1800 supplies power to the electric motor 1610 ofthe motor assembly 1600 to rotate the drive shaft 1710 of the handledrive system 1700, and the drive shaft 2710 of the shaft drive system2700, in a direction which closes the jaw assembly 7100 of the endeffector 7000. The mechanism for converting the rotation of the driveshaft 2710 to a closure motion of the jaw assembly 7100 is discussed ingreater detail below. So long as the clamping trigger 2610 is held inits actuated position, the electric motor 1610 will rotate the driveshaft 1710 until the jaw assembly 7100 reaches its fully-clampedposition. When the jaw assembly 7100 reaches its fully-clamped position,the handle control system 1800 cuts the electrical power to the electricmotor 1610. The handle control system 1800 can determine when the jawassembly 7100 has reached its fully-clamped position in any suitablemanner. For instance, the handle control system 1800 can comprise anencoder system which monitors the rotation of, and counts the rotationsof, the output shaft of the electric motor 1610 and, once the number ofrotations reaches a predetermined threshold, the handle control system1800 can discontinue supplying power to the electric motor 1610. In atleast one instance, the end effector assembly 7000 can comprise one ormore sensors configured to detect when the jaw assembly 7100 has reachedits fully-clamped position. In at least one such instance, the sensorsin the end effector 7000 are in signal communication with the handlecontrol system 1800 via electrical circuits extending through the shaftassembly 2000 which can include the electrical contacts 1520 and 2520,for example.

When the clamping trigger 2610 is rotated distally out of its proximalposition, the switch 2115 is opened which is detected by the shaftcontrol system 2800 and communicated to the handle control system 1800via the communication systems 2900 and 1900. Upon receiving a signalthat the clamping trigger 2610 has been moved out of its actuatedposition, the handle control system 1800 reverses the polarity of thevoltage differential being applied to the electric motor 1610 of themotor assembly 1600 to rotate the drive shaft 1710 of the handle drivesystem 1700, and the drive shaft 2710 of the shaft drive system 2700, inan opposite direction which, as a result, opens the jaw assembly 7100 ofthe end effector 7000. When the jaw assembly 7100 reaches its fully-openposition, the handle control system 1800 cuts the electrical power tothe electric motor 1610. The handle control system 1800 can determinewhen the jaw assembly 7100 has reached its fully-open position in anysuitable manner. For instance, the handle control system 1800 canutilize the encoder system and/or the one or more sensors describedabove to determine the configuration of the jaw assembly 7100. In viewof the above, the clinician needs to be mindful about holding theclamping trigger 2610 in its actuated position in order to maintain thejaw assembly 7100 in its clamped configuration as, otherwise, thecontrol system 1800 will open jaw assembly 7100. With this in mind, theshaft assembly 2000 further comprises an actuator latch 2630 configuredto releasably hold the clamping trigger 2610 in its actuated position toprevent the accidental opening of the jaw assembly 7100. The actuatorlatch 2630 can be manually released, or otherwise defeated, by theclinician to allow the clamping trigger 2610 to be rotated distally andopen the jaw assembly 7100.

The clamping trigger system 2600 further comprises a resilient biasingmember, such as a torsion spring, for example, configured to resist theclosure of the clamping trigger system 2600. The torsion spring can alsoassist in reducing and/or mitigating sudden movements and/or jitter ofthe clamping trigger 2610. Such a torsion spring can also automaticallyreturn the clamping trigger 2610 to its unactuated position when theclamping trigger 2610 is released. The actuator latch 2630 discussedabove can suitably hold the clamping trigger 2610 in its actuatedposition against the biasing force of the torsion spring.

As discussed above, the control system 1800 operates the electric motor1610 to open and close the jaw assembly 7100. The control system 1800 isconfigured to open and close the jaw assembly 7100 at the same speed. Insuch instances, the control system 1800 applies the same voltage pulsesto the electric motor 1610, albeit with different voltage polarities,when opening and closing the jaw assembly 7100. That said, the controlsystem 1800 can be configured to open and close the jaw assembly 7100 atdifferent speeds. For instance, the jaw assembly 7100 can be closed at afirst speed and opened at a second speed which is faster than the firstspeed. In such instances, the slower closing speed affords the clinicianan opportunity to better position the jaw assembly 7100 while clampingthe tissue. Alternatively, the control system 1800 can open the jawassembly 7100 at a slower speed. In such instances, the slower openingspeed reduces the possibility of the opening jaws colliding withadjacent tissue. In either event, the control system 1800 can decreasethe duration of the voltage pulses and/or increase the duration betweenthe voltage pulses to slow down and/or speed up the movement of the jawassembly 7100.

As discussed above, the control system 1800 is configured to interpretthe position of the clamping trigger 2610 as a command to position thejaw assembly 7100 in a specific configuration. For instance, the controlsystem 1800 is configured to interpret the proximal-most position of theclamping trigger 2610 as a command to close the jaw assembly 7100 andany other position of the clamping trigger as a command to open the jawassembly 7100. That said, the control system 1800 can be configured tointerpret the position of the clamping trigger 2610 in a proximal rangeof positions, instead of a single position, as a command to close thejaw assembly 7100. Such an arrangement can allow the jaw assembly 7000to be better responsive to the clinician's input. In such instances, therange of motion of the clamping trigger 2610 is divided into ranges—aproximal range which is interpreted as a command to close the jawassembly 7100 and a distal range which is interpreted as a command toopen the jaw assembly 7100. In at least one instance, the range ofmotion of the clamping trigger 2610 can have an intermediate rangebetween the proximal range and the distal range. When the clampingtrigger 2610 is in the intermediate range, the control system 1800 caninterpret the position of the clamping trigger 2610 as a command toneither open nor close the jaw assembly 7100. Such an intermediate rangecan prevent, or reduce the possibility of, jitter between the openingand closing ranges. In the instances described above, the control system1800 can be configured to ignore cumulative commands to open or closethe jaw assembly 7100. For instance, if the closure trigger 2610 hasalready been fully retracted into its proximal-most position, thecontrol assembly 1800 can ignore the motion of the clamping trigger 2610in the proximal, or clamping, range until the clamping trigger 2610enters into the distal, or opening, range wherein, at such point, thecontrol system 1800 can then actuate the electric motor 1610 to open thejaw assembly 7100.

In certain instances, further to the above, the position of the clampingtrigger 2610 within the clamping trigger range, or at least a portion ofthe clamping trigger range, can allow the clinician to control the speedof the electric motor 1610 and, thus, the speed in which the jawassembly 7100 is being opened or closed by the control assembly 1800. Inat least one instance, the sensor 2115 comprises a Hall Effect sensor,and/or any other suitable sensor, configured to detect the position ofthe clamping trigger 2610 between its distal, unactuated position andits proximal, fully-actuated position. The Hall Effect sensor isconfigured to transmit a signal to the handle control system 1800 viathe shaft control system 2800 such that the handle control system 1800can control the speed of the electric motor 1610 in response to theposition of the clamping trigger 2610. In at least one instance, thehandle control system 1800 controls the speed of the electric motor 1610proportionately, or in a linear manner, to the position of the clampingtrigger 2610. For example, if the clamping trigger 2610 is moved halfway through its range, then the handle control system 1800 will operatethe electric motor 1610 at half of the speed in which the electric motor1610 is operated when the clamping trigger 2610 is fully-retracted.Similarly, if the clamping trigger 2610 is moved a quarter way throughits range, then the handle control system 1800 will operate the electricmotor 1610 at a quarter of the speed in which the electric motor 1610 isoperated when the clamping trigger 2610 is fully-retracted. Otherembodiments are envisioned in which the handle control system 1800controls the speed of the electric motor 1610 in a non-linear manner tothe position of the clamping trigger 2610. In at least one instance, thecontrol system 1800 operates the electric motor 1610 slowly in thedistal portion of the clamping trigger range while quickly acceleratingthe speed of the electric motor 1610 in the proximal portion of theclamping trigger range.

As described above, the clamping trigger 2610 is movable to operate theelectric motor 1610 to open or close the jaw assembly 7100 of the endeffector 7000. The electric motor 1610 is also operable to rotate theend effector 7000 about a longitudinal axis and articulate the endeffector 7000 relative to the elongate shaft 2200 about the articulationjoint 2300 of the shaft assembly 2000. Referring primarily to FIGS. 7and 8, the drive module 1100 comprises an input system 1400 including arotation actuator 1420 and an articulation actuator 1430. The inputsystem 1400 further comprises a printed circuit board (PCB) 1410 whichis in signal communication with the printed circuit board (PCB) 1810 ofthe control system 1800. The drive module 1100 comprises an electricalcircuit, such as a flexible wiring harness or ribbon, for example, whichpermits the input system 1400 to communicate with the control system1800. The rotation actuator 1420 is rotatably supported on the housing1110 and is in signal communication with the input board 1410 and/orcontrol board 1810, as described in greater detail below. Thearticulation actuator 1430 is supported by and in signal communicationwith the input board 1410 and/or control board 1810, as also describedin greater detail below.

Referring primarily to FIGS. 8, 10, and 11, further to the above, thehandle housing 1110 comprises an annular groove or slot defined thereinadjacent the distal mounting interface 1130. The rotation actuator 1420comprises an annular ring 1422 rotatably supported within the annulargroove and, owing to the configuration of the sidewalls of the annulargroove, the annular ring 1422 is constrained from translatinglongitudinally and/or laterally with respect to the handle housing 1110.The annular ring 1422 is rotatable in a first, or clockwise, directionand a second, or counter-clockwise direction, about a longitudinal axisextending through the frame 1500 of the drive module 1100. The rotationactuator 1420 comprises one or more sensors configured to detect therotation of the annular ring 1422. In at least one instance, therotation actuator 1420 comprises a first sensor positioned on a firstside of the drive module 1100 and a second sensor positioned on asecond, or opposite, side of the drive module 1100 and the annular ring1422 comprises a detectable element which is detectable by the first andsecond sensors. The first sensor is configured to detect when theannular ring 1422 is rotated in the first direction and the secondsensor is configured to detect when the annular ring 1422 is rotated inthe second direction. When the first sensor detects that the annularring 1422 is rotated in the first direction, the handle control system1800 rotates the handle drive shaft 1710, the drive shaft 2710, and theend effector 7000 in the first direction, as described in greater detailbelow. Similarly, the handle control system 1800 rotates the handledrive shaft 1710, the drive shaft 2710, and the end effector 7000 in thesecond direction when the second sensor detects that the annular ring1422 is rotated in the second direction. In view of the above, thereader should appreciate that the clamping trigger 2610 and the rotationactuator 1420 are both operable to rotate the drive shaft 2710.

In various embodiments, further to the above, the first and secondsensors comprise switches which are mechanically closable by thedetectable element of the annular ring 1422. When the annular ring 1422is rotated in the first direction from a center position, the detectableelement closes the switch of the first sensor. When the switch of thefirst sensor is closed, the control system 1800 operates the electricmotor 1610 to rotate the end effector 7000 in the first direction. Whenthe annular ring 1422 is rotated in the second direction toward thecenter position, the detectable element is disengaged from the firstswitch and the first switch is re-opened. Once the first switch isre-opened, the control system 1800 cuts the power to the electric motor1610 to stop the rotation of the end effector 7000. Similarly, thedetectable element closes the switch of the second sensor when theannular ring 1422 is rotated in the second direction from the centerposition. When the switch of the second sensor is closed, the controlsystem 1800 operates the electric motor 1610 to rotate the end effector7000 in the second direction. When the annular ring 1422 is rotated inthe first direction toward the center position, the detectable elementis disengaged from the second switch and the second switch is re-opened.Once the second switch is re-opened, the control system 1800 cuts thepower to the electric motor 1610 to stop the rotation of the endeffector 7000.

In various embodiments, further to the above, the first and secondsensors of the rotation actuator 1420 comprise proximity sensors, forexample. In certain embodiments, the first and second sensors of therotation actuator 1420 comprise Hall Effect sensors, and/or any suitablesensors, configured to detect the distance between the detectableelement of the annular ring 1422 and the first and second sensors. Ifthe first Hall Effect sensor detects that the annular ring 1422 has beenrotated in the first direction, then, as discussed above, the controlsystem 1800 will rotate the end effector 7000 in the first direction. Inaddition, the control system 1800 can rotate the end effector 7000 at afaster speed when the detectable element is closer to the first HallEffect sensor than when the detectable element is further away from thefirst Hall Effect sensor. If the second Hall Effect sensor detects thatthe annular ring 1422 has been rotated in the second direction, then, asdiscussed above, the control system 1800 will rotate the end effector7000 in the second direction. In addition, the control system 1800 canrotate the end effector 7000 at a faster speed when the detectableelement is closer to the second Hall Effect sensor than when thedetectable element is further away from the second Hall Effect sensor.As a result, the speed in which the end effector 7000 is rotated is afunction of the amount, or degree, in which the annular ring 1422 isrotated. The control system 1800 is further configured to evaluate theinputs from both the first and second Hall Effect sensors whendetermining the direction and speed in which to rotate the end effector7000. In various instances, the control system 1800 can use the closestHall Effect sensor to the detectable element of the annular ring 1422 asa primary source of data and the Hall Effect sensor furthest away fromthe detectable element as a confirmational source of data todouble-check the data provided by the primary source of data. Thecontrol system 1800 can further comprise a data integrity protocol toresolve situations in which the control system 1800 is provided withconflicting data. In any event, the handle control system 1800 can enterinto a neutral state in which the handle control system 1800 does notrotate the end effector 7000 when the Hall Effect sensors detect thatthe detectable element is in its center position, or in a position whichis equidistant between the first Hall Effect sensor and the second HallEffect sensor. In at least one such instance, the control system 1800can enter into its neutral state when the detectable element is in acentral range of positions. Such an arrangement would prevent, or atleast reduce the possibility of, rotational jitter when the clinician isnot intending to rotate the end effector 7000.

Further to the above, the rotation actuator 1420 can comprise one ormore springs configured to center, or at least substantially center, therotation actuator 1420 when it is released by the clinician. In suchinstances, the springs can act to shut off the electric motor 1610 andstop the rotation of the end effector 7000. In at least one instance,the rotation actuator 1420 comprises a first torsion spring configuredto rotate the rotation actuator 1420 in the first direction and a secondtorsion spring configured to rotate the rotation actuator 1420 in thesecond direction. The first and second torsion springs can have thesame, or at least substantially the same, spring constant such that theforces and/or torques applied by the first and second torsion springsbalance, or at least substantially balance, the rotation actuator 1420in its center position.

In view of the above, the reader should appreciate that the clampingtrigger 2610 and the rotation actuator 1420 are both operable to rotatethe drive shaft 2710 and either, respectively, operate the jaw assembly7100 or rotate the end effector 7000. The system that uses the rotationof the drive shaft 2710 to selectively perform these functions isdescribed in greater detail below.

Referring to FIGS. 7 and 8, the articulation actuator 1430 comprises afirst push button 1432 and a second push button 1434. The first pushbutton 1432 is part of a first articulation control circuit and thesecond push button 1434 is part of a second articulation circuit of theinput system 1400. The first push button 1432 comprises a first switchthat is closed when the first push button 1432 is depressed. The handlecontrol system 1800 is configured to sense the closure of the firstswitch and, moreover, the closure of the first articulation controlcircuit. When the handle control system 1800 detects that the firstarticulation control circuit has been closed, the handle control system1800 operates the electric motor 1610 to articulate the end effector7000 in a first articulation direction about the articulation joint2300. When the first push button 1432 is released by the clinician, thefirst articulation control circuit is opened which, once detected by thecontrol system 1800, causes the control system 1800 to cut the power tothe electric motor 1610 to stop the articulation of the end effector7000.

In various instances, further to the above, the articulation range ofthe end effector 7000 is limited and the control system 1800 can utilizethe encoder system discussed above for monitoring the rotational outputof the electric motor 1610, for example, to monitor the amount, ordegree, in which the end effector 7000 is rotated in the firstdirection. In addition to or in lieu of the encoder system, the shaftassembly 2000 can comprise a first sensor configured to detect when theend effector 7000 has reached the limit of its articulation in the firstdirection. In any event, when the control system 1800 determines thatthe end effector 7000 has reached the limit of articulation in the firstdirection, the control system 1800 can cut the power to the electricmotor 1610 to stop the articulation of the end effector 7000.

Similar to the above, the second push button 1434 comprises a secondswitch that is closed when the second push button 1434 is depressed. Thehandle control system 1800 is configured to sense the closure of thesecond switch and, moreover, the closure of the second articulationcontrol circuit. When the handle control system 1800 detects that thesecond articulation control circuit has been closed, the handle controlsystem 1800 operates the electric motor 1610 to articulate the endeffector 7000 in a second direction about the articulation joint 2300.When the second push button 1434 is released by the clinician, thesecond articulation control circuit is opened which, once detected bythe control system 1800, causes the control system 1800 to cut the powerto the electric motor 1610 to stop the articulation of the end effector7000.

In various instances, the articulation range of the end effector 7000 islimited and the control system 1800 can utilize the encoder systemdiscussed above for monitoring the rotational output of the electricmotor 1610, for example, to monitor the amount, or degree, in which theend effector 7000 is rotated in the second direction. In addition to orin lieu of the encoder system, the shaft assembly 2000 can comprise asecond sensor configured to detect when the end effector 7000 hasreached the limit of its articulation in the second direction. In anyevent, when the control system 1800 determines that the end effector7000 has reached the limit of articulation in the second direction, thecontrol system 1800 can cut the power to the electric motor 1610 to stopthe articulation of the end effector 7000.

As described above, the end effector 7000 is articulatable in a firstdirection (FIG. 16) and/or a second direction (FIG. 17) from a center,or unarticulated, position (FIG. 15). Once the end effector 7000 hasbeen articulated, the clinician can attempt to re-center the endeffector 7000 by using the first and second articulation push buttons1432 and 1434. As the reader can appreciate, the clinician may struggleto re-center the end effector 7000 as, for instance, the end effector7000 may not be entirely visible once it is positioned in the patient.In some instances, the end effector 7000 may not fit back through atrocar if the end effector 7000 is not re-centered, or at leastsubstantially re-centered. With that in mind, the control system 1800 isconfigured to provide feedback to the clinician when the end effector7000 is moved into its unarticulated, or centered, position. In at leastone instance, the feedback comprises audio feedback and the handlecontrol system 1800 can comprise a speaker which emits a sound, such asa beep, for example, when the end effector 7000 is centered. In certaininstances, the feedback comprises visual feedback and the handle controlsystem 1800 can comprise a light emitting diode (LED), for example,positioned on the handle housing 1110 which flashes when the endeffector 7000 is centered. In various instances, the feedback compriseshaptic feedback and the handle control system 1800 can comprise anelectric motor comprising an eccentric element which vibrates the handle1000 when the end effector 7000 is centered. Manually re-centering theend effector 7000 in this way can be facilitated by the control system1800 slowing the motor 1610 when the end effector 7000 is approachingits centered position. In at least one instance, the control system 1800slows the articulation of the end effector 7000 when the end effector7000 is within approximately 5 degrees of center in either direction,for example.

In addition to or in lieu of the above, the handle control system 1800can be configured to re-center the end effector 7000. In at least onesuch instance, the handle control system 1800 can re-center the endeffector 7000 when both of the articulation buttons 1432 and 1434 of thearticulation actuator 1430 are depressed at the same time. When thehandle control system 1800 comprises an encoder system configured tomonitor the rotational output of the electric motor 1610, for example,the handle control system 1800 can determine the amount and direction ofarticulation needed to re-center, or at least substantially re-center,the end effector 7000. In various instances, the input system 1400 cancomprise a home button, for example, which, when depressed,automatically centers the end effector 7000.

Referring primarily to FIGS. 5 and 6, the elongate shaft 2200 of theshaft assembly 2000 comprises an outer housing, or tube, 2210 mounted tothe proximal housing 2110 of the proximal portion 2100. The outerhousing 2210 comprises a longitudinal aperture 2230 extendingtherethrough and a proximal flange 2220 which secures the outer housing2210 to the proximal housing 2110. The frame 2500 of the shaft assembly2000 extends through the longitudinal aperture 2230 of the elongateshaft 2200. More specifically, the shaft 2510 of the shaft frame 2500necks down into a smaller shaft 2530 which extends through thelongitudinal aperture 2230. That said, the shaft frame 2500 can compriseany suitable arrangement. The drive system 2700 of the shaft assembly2000 also extends through the longitudinal aperture 2230 of the elongateshaft 2200. More specifically, the drive shaft 2710 of the shaft drivesystem 2700 necks down into a smaller drive shaft 2730 which extendsthrough the longitudinal aperture 2230. That said, the shaft drivesystem 2700 can comprise any suitable arrangement.

Referring primarily to FIGS. 20, 23, and 24, the outer housing 2210 ofthe elongate shaft 2200 extends to the articulation joint 2300. Thearticulation joint 2300 comprises a proximal frame 2310 mounted to theouter housing 2210 such that there is little, if any, relativetranslation and/or rotation between the proximal frame 2310 and theouter housing 2210. Referring primarily to FIG. 22, the proximal frame2310 comprises an annular portion 2312 mounted to the sidewall of theouter housing 2210 and tabs 2314 extending distally from the annularportion 2312. The articulation joint 2300 further comprises links 2320and 2340 which are rotatably mounted to the frame 2310 and mounted to anouter housing 2410 of the distal attachment portion 2400. The link 2320comprises a distal end 2322 mounted to the outer housing 2410. Morespecifically, the distal end 2322 of the link 2320 is received andfixedly secured within a mounting slot 2412 defined in the outer housing2410. Similarly, the link 2340 comprises a distal end 2342 mounted tothe outer housing 2410. More specifically, the distal end 2342 of thelink 2340 is received and fixedly secured within a mounting slot definedin the outer housing 2410. The link 2320 comprises a proximal end 2324rotatably coupled to a tab 2314 of the proximal articulation frame 2310.Although not illustrated in FIG. 22, a pin extends through aperturesdefined in the proximal end 2324 and the tab 2314 to define a pivot axistherebetween. Similarly, the link 2340 comprises a proximal end 2344rotatably coupled to a tab 2314 of the proximal articulation frame 2310.Although not illustrated in FIG. 22, a pin extends through aperturesdefined in the proximal end 2344 and the tab 2314 to define a pivot axistherebetween. These pivot axes are collinear, or at least substantiallycollinear, and define an articulation axis A of the articulation joint2300.

Referring primarily to FIGS. 20, 23, and 24, the outer housing 2410 ofthe distal attachment portion 2400 comprises a longitudinal aperture2430 extending therethrough. The longitudinal aperture 2430 isconfigured to receive a proximal attachment portion 7400 of the endeffector 7000. The end effector 7000 comprises an outer housing 6230which is closely received within the longitudinal aperture 2430 of thedistal attachment portion 2400 such that there is little, if any,relative radial movement between the proximal attachment portion 7400 ofthe end effector 7000 and the distal attachment portion 2400 of theshaft assembly 2000. The proximal attachment portion 7400 furthercomprises an annular array of lock notches 7410 defined on the outerhousing 6230 which is releasably engaged by an end effector lock 6400 inthe distal attachment portion 2400 of the shaft assembly 2000. When theend effector lock 6400 is engaged with the array of lock notches 7410,the end effector lock 6400 prevents, or at least inhibits, relativelongitudinal movement between the proximal attachment portion 7400 ofthe end effector 7000 and the distal attachment portion 2400 of theshaft assembly 2000. As a result of the above, only relative rotationbetween the proximal attachment portion 7400 of the end effector 7000and the distal attachment portion 2400 of the shaft assembly 2000 ispermitted. To this end, the outer housing 6230 of the end effector 7000is closely received within the longitudinal aperture 2430 defined in thedistal attachment portion 2400 of the shaft assembly 2000.

Further to the above, referring to FIG. 21, the outer housing 6230further comprises an annular slot, or recess, 6270 defined therein whichis configured to receive an O-ring 6275 therein. The O-ring 6275 iscompressed between the outer housing 6230 and the sidewall of thelongitudinal aperture 2430 when the end effector 7000 is inserted intothe distal attachment portion 2400. The O-ring 6275 is configured toresist, but permit, relative rotation between the end effector 7000 andthe distal attachment portion 2400 such that the O-ring 6275 canprevent, or reduce the possibility of, unintentional relative rotationbetween the end effector 7000 and the distal attachment portion 2400. Invarious instances, the O-ring 6275 can provide a seal between the endeffector 7000 and the distal attachment portion 2400 to prevent, or atleast reduce the possibility of, fluid ingress into the shaft assembly2000, for example.

Referring to FIGS. 14-21, the jaw assembly 7100 of the end effector 7000comprises a first jaw 7110 and a second jaw 7120. Each jaw 7110, 7120comprises a distal end which is configured to assist a clinician indissecting tissue with the end effector 7000. Each jaw 7110, 7120further comprises a plurality of teeth which are configured to assist aclinician in grasping and holding onto tissue with the end effector7000. Moreover, referring primarily to FIG. 21, each jaw 7110, 7120comprises a proximal end, i.e., proximal ends 7115, 7125, respectively,which rotatably connect the jaws 7110, 7120 together. Each proximal end7115, 7125 comprises an aperture extending therethrough which isconfigured to closely receive a pin 7130 therein. The pin 7130 comprisesa central body 7135 closely received within the apertures defined in theproximal ends 7115, 7125 of the jaws 7110, 7120 such that there islittle, if any, relative translation between the jaws 7110, 7120 and thepin 7130. The pin 7130 defines a jaw axis J about which the jaws 7110,7120 can be rotated and, also, rotatably mounts the jaws 7110, 7120 tothe outer housing 6230 of the end effector 7000. More specifically, theouter housing 6230 comprises distally-extending tabs 6235 havingapertures defined therein which are also configured to closely receivethe pin 7130 such that the jaw assembly 7100 does not translate relativeto a shaft portion 7200 of the end effector 7000. The pin 7130 furthercomprises enlarged ends which prevent the jaws 7110, 7120 from becomingdetached from the pin 7130 and also prevents the jaw assembly 7100 frombecoming detached from the shaft portion 7200. This arrangement definesa rotation joint 7300.

Referring primarily to FIGS. 21 and 23, the jaws 7110 and 7120 arerotatable between their open and closed positions by a jaw assemblydrive including drive links 7140, a drive nut 7150, and a drive screw6130. As described in greater detail below, the drive screw 6130 isselectively rotatable by the drive shaft 2730 of the shaft drive system2700. The drive screw 6130 comprises an annular flange 6132 which isclosely received within a slot, or groove, 6232 (FIG. 25) defined in theouter housing 6230 of the end effector 7000. The sidewalls of the slot6232 are configured to prevent, or at least inhibit, longitudinal and/orradial translation between the drive screw 6130 and the outer housing6230, but yet permit relative rotational motion between the drive screw6130 and the outer housing 6230. The drive screw 6130 further comprisesa threaded end 6160 which is threadably engaged with a threaded aperture7160 defined in the drive nut 7150. The drive nut 7150 is constrainedfrom rotating with the drive screw 6130 and, as a result, the drive nut7150 is translated when the drive screw 6130 is rotated. In use, thedrive screw 6130 is rotated in a first direction to displace the drivenut 7150 proximally and in a second, or opposite, direction to displacethe drive nut 7150 distally. The drive nut 7150 further comprises adistal end 7155 comprising an aperture defined therein which isconfigured to closely receive pins 7145 extending from the drive links7140. Referring primarily to FIG. 21, a first drive link 7140 isattached to one side of the distal end 7155 and a second drive link 7140is attached to the opposite side of the distal end 7155. The first drivelink 7140 comprises another pin 7145 extending therefrom which isclosely received in an aperture defined in the proximal end 7115 of thefirst jaw 7110 and, similarly, the second drive link 7140 comprisesanother pin extending therefrom which is closely received in an aperturedefined in the proximal end 7125 of the second jaw 7120. As a result ofthe above, the drive links 7140 operably connect the jaws 7110 and 7120to the drive nut 7150. When the drive nut 7150 is driven proximally bythe drive screw 6130, as described above, the jaws 7110, 7120 arerotated into the closed, or clamped, configuration. Correspondingly, thejaws 7110, 7120 are rotated into their open configuration when the drivenut 7150 is driven distally by the drive screw 6130.

As discussed above, the control system 1800 is configured to actuate theelectric motor 1610 to perform three different end effectorfunctions—clamping/opening the jaw assembly 7100 (FIGS. 14 and 15),rotating the end effector 7000 about a longitudinal axis (FIGS. 18 and19), and articulating the end effector 7000 about an articulation axis(FIGS. 16 and 17). Referring primarily to FIGS. 26 and 27, the controlsystem 1800 is configured to operate a transmission 6000 to selectivelyperform these three end effector functions. The transmission 6000comprises a first clutch system 6100 configured to selectively transmitthe rotation of the drive shaft 2730 to the drive screw 6130 of the endeffector 7000 to open or close the jaw assembly 7100, depending on thedirection in which the drive shaft 2730 is rotated. The transmission6000 further comprises a second clutch system 6200 configured toselectively transmit the rotation of the drive shaft 2730 to the outerhousing 6230 of the end effector 7000 to rotate the end effector 7000about the longitudinal axis L. The transmission 6000 also comprises athird clutch system 6300 configured to selectively transmit the rotationof the drive shaft 2730 to the articulation joint 2300 to articulate thedistal attachment portion 2400 and the end effector 7000 about thearticulation axis A. The clutch systems 6100, 6200, and 6300 are inelectrical communication with the control system 1800 via electricalcircuits extending through the shaft 2510, the connector pins 2520, theconnector pins 1520, and the shaft 1510, for example. In at least oneinstance, each of these clutch control circuits comprises two connectorpins 2520 and two connector pins 1520, for example.

In various instances, further to the above, the shaft 2510 and/or theshaft 1510 comprise a flexible circuit including electrical traces whichform part of the clutch control circuits. The flexible circuit cancomprise a ribbon, or substrate, with conductive pathways definedtherein and/or thereon. The flexible circuit can also comprise sensorsand/or any solid state component, such as signal smoothing capacitors,for example, mounted thereto. In at least one instance, each of theconductive pathways can comprise one or more signal smoothing capacitorswhich can, among other things, even out fluctuations in signalstransmitted through the conductive pathways. In various instances, theflexible circuit can be coated with at least one material, such as anelastomer, for example, which can seal the flexible circuit againstfluid ingress.

Referring primarily to FIG. 28, the first clutch system 6100 comprises afirst clutch 6110, an expandable first drive ring 6120, and a firstelectromagnetic actuator 6140. The first clutch 6110 comprises anannular ring and is slideably disposed on the drive shaft 2730. Thefirst clutch 6110 is comprised of a magnetic material and is movablebetween a disengaged, or unactuated, position (FIG. 28) and an engaged,or actuated, position (FIG. 29) by electromagnetic fields EF generatedby the first electromagnetic actuator 6140. In various instances, thefirst clutch 6110 is at least partially comprised of iron and/or nickel,for example. In at least one instance, the first clutch 6110 comprises apermanent magnet. As illustrated in FIG. 22A, the drive shaft 2730comprises one or more longitudinal key slots 6115 defined therein whichare configured to constrain the longitudinal movement of the clutch 6110relative to the drive shaft 2730. More specifically, the clutch 6110comprises one or more keys extending into the key slots 6115 such thatthe distal ends of the key slots 6115 stop the distal movement of theclutch 6110 and the proximal ends of the key slots 6115 stop theproximal movement of the clutch 6110.

When the first clutch 6110 is in its disengaged position (FIG. 28), thefirst clutch 6110 rotates with the drive shaft 2130 but does nottransmit rotational motion to the first drive ring 6120. As can be seenin FIG. 28, the first clutch 6110 is separated from, or not in contactwith, the first drive ring 6120. As a result, the rotation of the driveshaft 2730 and the first clutch 6110 is not transmitted to the drivescrew 6130 when the first clutch assembly 6100 is in its disengagedstate. When the first clutch 6110 is in its engaged position (FIG. 29),the first clutch 6110 is engaged with the first drive ring 6120 suchthat the first drive ring 6120 is expanded, or stretched, radiallyoutwardly into contact with the drive screw 6130. In at least oneinstance, the first drive ring 6120 comprises an elastomeric band, forexample. As can be seen in FIG. 29, the first drive ring 6120 iscompressed against an annular inner sidewall 6135 of the drive screw6130. As a result, the rotation of the drive shaft 2730 and the firstclutch 6110 is transmitted to the drive screw 6130 when the first clutchassembly 6100 is in its engaged state. Depending on the direction inwhich the drive shaft 2730 is rotated, the first clutch assembly 6100can move the jaw assembly 7100 into its open and closed configurationswhen the first clutch assembly 6100 is in its engaged state.

As described above, the first electromagnetic actuator 6140 isconfigured to generate magnetic fields to move the first clutch 6110between its disengaged (FIG. 28) and engaged (FIG. 29) positions. Forinstance, referring to FIG. 28, the first electromagnetic actuator 6140is configured to emit a magnetic field EF_(L) which repulses, or drives,the first clutch 6110 away from the first drive ring 6120 when the firstclutch assembly 6100 is in its disengaged state. The firstelectromagnetic actuator 6140 comprises one or more wound coils in acavity defined in the shaft frame 2530 which generate the magnetic fieldEF_(L) when current flows in a first direction through a firstelectrical clutch circuit including the wound coils. The control system1800 is configured to apply a first voltage polarity to the firstelectrical clutch circuit to create the current flowing in the firstdirection. The control system 1800 can continuously apply the firstvoltage polarity to the first electric shaft circuit to continuouslyhold the first clutch 6110 in its disengaged position. While such anarrangement can prevent the first clutch 6110 from unintentionallyengaging the first drive ring 6120, such an arrangement can also consumea lot of power. Alternatively, the control system 1800 can apply thefirst voltage polarity to the first electrical clutch circuit for asufficient period of time to position the first clutch 6110 in itsdisengaged position and then discontinue applying the first voltagepolarity to the first electric clutch circuit, thereby resulting in alower consumption of power. That being said, the first clutch assembly6100 further comprises a first clutch lock 6150 mounted in the drivescrew 6130 which is configured to releasably hold the first clutch 6110in its disengaged position. The first clutch lock 6150 is configured toprevent, or at least reduce the possibility of, the first clutch 6110from becoming unintentionally engaged with the first drive ring 6120.When the first clutch 6110 is in its disengaged position, as illustratedin FIG. 28, the first clutch lock 6150 interferes with the free movementof the first clutch 6110 and holds the first clutch 6110 in position viaa friction force and/or an interference force therebetween. In at leastone instance, the first clutch lock 6150 comprises an elastomeric plug,seat, or detent, comprised of rubber, for example. In certain instances,the first clutch lock 6150 comprises a permanent magnet which holds thefirst clutch 6110 in its disengaged position by an electromagneticforce. In any event, the first electromagnetic actuator 6140 can applyan electromagnetic pulling force to the first clutch 6110 that overcomesthese forces, as described in greater detail below.

Further to the above, referring to FIG. 29, the first electromagneticactuator 6140 is configured to emit a magnetic field EF_(D) which pulls,or drives, the first clutch 6110 toward the first drive ring 6120 whenthe first clutch assembly 6100 is in its engaged state. The coils of thefirst electromagnetic actuator 6140 generate the magnetic field EF_(D)when current flows in a second, or opposite, direction through the firstelectrical clutch circuit. The control system 1800 is configured toapply an opposite voltage polarity to the first electrical clutchcircuit to create the current flowing in the opposite direction. Thecontrol system 1800 can continuously apply the opposite voltage polarityto the first electrical clutch circuit to continuously hold the firstclutch 6110 in its engaged position and maintain the operable engagementbetween the first drive ring 6120 and the drive screw 6130.Alternatively, the first clutch 6110 can be configured to become wedgedwithin the first drive ring 6120 when the first clutch 6110 is in itsengaged position and, in such instances, the control system 1800 may notneed to continuously apply a voltage polarity to the first electricalclutch circuit to hold the first clutch assembly 6100 in its engagedstate. In such instances, the control system 1800 can discontinueapplying the voltage polarity once the first clutch 6110 has beensufficiently wedged in the first drive ring 6120.

Notably, further to the above, the first clutch lock 6150 is alsoconfigured to lockout the jaw assembly drive when the first clutch 6110is in its disengaged position. More specifically, referring again toFIG. 28, the first clutch 6110 pushes the first clutch lock 6150 in thedrive screw 6130 into engagement with the outer housing 6230 of the endeffector 7000 when the first clutch 6110 is in its disengaged positionsuch that the drive screw 6130 does not rotate, or at leastsubstantially rotate, relative to the outer housing 6230. The outerhousing 6230 comprises a slot 6235 defined therein which is configuredto receive the first clutch lock 6150. When the first clutch 6110 ismoved into its engaged position, referring to FIG. 29, the first clutch6110 is no longer engaged with the first clutch lock 6150 and, as aresult, the first clutch lock 6150 is no longer biased into engagementwith the outer housing 6230 and the drive screw 6130 can rotate freelywith respect to the outer housing 6230. As a result of the above, thefirst clutch 6110 can do at least two things—operate the jaw drive whenthe first clutch 6110 is in its engaged position and lock out the jawdrive when the first clutch 6110 is in its disengaged position.

Moreover, further to the above, the threads of the threaded portions6160 and 7160 can be configured to prevent, or at least resist,backdriving of the jaw drive. In at least one instance, the thread pitchand/or angle of the threaded portions 6160 and 7160, for example, can beselected to prevent the backdriving, or unintentional opening, of thejaw assembly 7100. As a result of the above, the possibility of the jawassembly 7100 unintentionally opening or closing is prevented, or atleast reduced.

Referring primarily to FIG. 30, the second clutch system 6200 comprisesa second clutch 6210, an expandable second drive ring 6220, and a secondelectromagnetic actuator 6240. The second clutch 6210 comprises anannular ring and is slideably disposed on the drive shaft 2730. Thesecond clutch 6210 is comprised of a magnetic material and is movablebetween a disengaged, or unactuated, position (FIG. 30) and an engaged,or actuated, position (FIG. 31) by electromagnetic fields EF generatedby the second electromagnetic actuator 6240. In various instances, thesecond clutch 6210 is at least partially comprised of iron and/ornickel, for example. In at least one instance, the second clutch 6210comprises a permanent magnet. As illustrated in FIG. 22A, the driveshaft 2730 comprises one or more longitudinal key slots 6215 definedtherein which are configured to constrain the longitudinal movement ofthe second clutch 6210 relative to the drive shaft 2730. Morespecifically, the second clutch 6210 comprises one or more keysextending into the key slots 6215 such that the distal ends of the keyslots 6215 stop the distal movement of the second clutch 6210 and theproximal ends of the key slots 6215 stop the proximal movement of thesecond clutch 6210.

When the second clutch 6210 is in its disengaged position, referring toFIG. 30, the second clutch 6210 rotates with the drive shaft 2730 butdoes not transmit rotational motion to the second drive ring 6220. Ascan be seen in FIG. 30, the second clutch 6210 is separated from, or notin contact with, the second drive ring 6220. As a result, the rotationof the drive shaft 2730 and the second clutch 6210 is not transmitted tothe outer housing 6230 of the end effector 7000 when the second clutchassembly 6200 is in its disengaged state. When the second clutch 6210 isin its engaged position (FIG. 31), the second clutch 6210 is engagedwith the second drive ring 6220 such that the second drive ring 6220 isexpanded, or stretched, radially outwardly into contact with the outerhousing 6230. In at least one instance, the second drive ring 6220comprises an elastomeric band, for example. As can be seen in FIG. 31,the second drive ring 6220 is compressed against an annular innersidewall 7415 of the outer housing 6230. As a result, the rotation ofthe drive shaft 2730 and the second clutch 6210 is transmitted to theouter housing 6230 when the second clutch assembly 6200 is in itsengaged state. Depending on the direction in which the drive shaft 2730is rotated, the second clutch assembly 6200 can rotate the end effector7000 in a first direction or a second direction about the longitudinalaxis L when the second clutch assembly 6200 is in its engaged state.

As described above, the second electromagnetic actuator 6240 isconfigured to generate magnetic fields to move the second clutch 6210between its disengaged (FIG. 30) and engaged (FIG. 31) positions. Forinstance, the second electromagnetic actuator 6240 is configured to emita magnetic field EF_(L) which repulses, or drives, the second clutch6210 away from the second drive ring 6220 when the second clutchassembly 6200 is in its disengaged state. The second electromagneticactuator 6240 comprises one or more wound coils in a cavity defined inthe shaft frame 2530 which generate the magnetic field EF_(L) whencurrent flows in a first direction through a second electrical clutchcircuit including the wound coils. The control system 1800 is configuredto apply a first voltage polarity to the second electrical clutchcircuit to create the current flowing in the first direction. Thecontrol system 1800 can continuously apply the first voltage polarity tothe second electric clutch circuit to continuously hold the secondclutch 6120 in its disengaged position. While such an arrangement canprevent the second clutch 6210 from unintentionally engaging the seconddrive ring 6220, such an arrangement can also consume a lot of power.Alternatively, the control system 1800 can apply the first voltagepolarity to the second electrical clutch circuit for a sufficient periodof time to position the second clutch 6210 in its disengaged positionand then discontinue applying the first voltage polarity to the secondelectric clutch circuit, thereby resulting in a lower consumption ofpower. That being said, the second clutch assembly 6200 furthercomprises a second clutch lock 6250 mounted in the outer housing 6230which is configured to releasably hold the second clutch 6210 in itsdisengaged position. Similar to the above, the second clutch lock 6250can prevent, or at least reduce the possibility of, the second clutch6210 from becoming unintentionally engaged with the second drive ring6220. When the second clutch 6210 is in its disengaged position, asillustrated in FIG. 30, the second clutch lock 6250 interferes with thefree movement of the second clutch 6210 and holds the second clutch 6210in position via a friction and/or interference force therebetween. In atleast one instance, the second clutch lock 6250 comprises an elastomericplug, seat, or detent, comprised of rubber, for example. In certaininstances, the second clutch lock 6250 comprises a permanent magnetwhich holds the second clutch 6210 in its disengaged position by anelectromagnetic force. That said, the second electromagnetic actuator6240 can apply an electromagnetic pulling force to the second clutch6210 that overcomes these forces, as described in greater detail below.

Further to the above, referring to FIG. 31, the second electromagneticactuator 6240 is configured to emit a magnetic field EF_(D) which pulls,or drives, the second clutch 6210 toward the second drive ring 6220 whenthe second clutch assembly 6200 is in its engaged state. The coils ofthe second electromagnetic actuator 6240 generate the magnetic fieldEF_(D) when current flows in a second, or opposite, direction throughthe second electrical shaft circuit. The control system 1800 isconfigured to apply an opposite voltage polarity to the secondelectrical shaft circuit to create the current flowing in the oppositedirection. The control system 1800 can continuously apply the oppositevoltage polarity to the second electric shaft circuit to continuouslyhold the second clutch 6210 in its engaged position and maintain theoperable engagement between the second drive ring 6220 and the outerhousing 6230. Alternatively, the second clutch 6210 can be configured tobecome wedged within the second drive ring 6220 when the second clutch6210 is in its engaged position and, in such instances, the controlsystem 1800 may not need to continuously apply a voltage polarity to thesecond shaft electrical circuit to hold the second clutch assembly 6200in its engaged state. In such instances, the control system 1800 candiscontinue applying the voltage polarity once the second clutch 6210has been sufficiently wedged in the second drive ring 6220.

Notably, further to the above, the second clutch lock 6250 is alsoconfigured to lockout the rotation of the end effector 7000 when thesecond clutch 6210 is in its disengaged position. More specifically,referring again to FIG. 30, the second clutch 6210 pushes the secondclutch lock 6250 in the outer shaft 6230 into engagement with thearticulation link 2340 when the second clutch 6210 is in its disengagedposition such that the end effector 7000 does not rotate, or at leastsubstantially rotate, relative to the distal attachment portion 2400 ofthe shaft assembly 2000. As illustrated in FIG. 27, the second clutchlock 6250 is positioned or wedged within a slot, or channel, 2345defined in the articulation link 2340 when the second clutch 6210 is inits disengaged position. As a result of the above, the possibility ofthe end effector 7000 unintentionally rotating is prevented, or at leastreduced. Moreover, as a result of the above, the second clutch 6210 cando at least two things—operate the end effector rotation drive when thesecond clutch 6210 is in its engaged position and lock out the endeffector rotation drive when the second clutch 6210 is in its disengagedposition.

Referring primarily to FIGS. 22, 24, and 25, the shaft assembly 2000further comprises an articulation drive system configured to articulatethe distal attachment portion 2400 and the end effector 7000 about thearticulation joint 2300. The articulation drive system comprises anarticulation drive 6330 rotatably supported within the distal attachmentportion 2400. That said, the articulation drive 6330 is closely receivedwithin the distal attachment portion 2400 such that the articulationdrive 6330 does not translate, or at least substantially translate,relative to the distal attachment portion 2400. The articulation drivesystem of the shaft assembly 2000 further comprises a stationary gear2330 fixedly mounted to the articulation frame 2310. More specifically,the stationary gear 2330 is fixedly mounted to a pin connecting a tab2314 of the articulation frame 2310 and the articulation link 2340 suchthat the stationary gear 2330 does not rotate relative to thearticulation frame 2310. The stationary gear 2330 comprises a centralbody 2335 and an annular array of stationary teeth 2332 extending aroundthe perimeter of the central body 2335. The articulation drive 6330comprises an annular array of drive teeth 6332 which is meshinglyengaged with the stationary teeth 2332. When the articulation drive 6330is rotated, the articulation drive 6330 pushes against the stationarygear 2330 and articulates the distal attachment portion 2400 of theshaft assembly 2000 and the end effector 7000 about the articulationjoint 2300.

Referring primarily to FIG. 32, the third clutch system 6300 comprises athird clutch 6310, an expandable third drive ring 6320, and a thirdelectromagnetic actuator 6340. The third clutch 6310 comprises anannular ring and is slideably disposed on the drive shaft 2730. Thethird clutch 6310 is comprised of a magnetic material and is movablebetween a disengaged, or unactuated, position (FIG. 32) and an engaged,or actuated, position (FIG. 33) by electromagnetic fields EF generatedby the third electromagnetic actuator 6340. In various instances, thethird clutch 6310 is at least partially comprised of iron and/or nickel,for example. In at least one instance, the third clutch 6310 comprises apermanent magnet. As illustrated in FIG. 22A, the drive shaft 2730comprises one or more longitudinal key slots 6315 defined therein whichare configured to constrain the longitudinal movement of the thirdclutch 6310 relative to the drive shaft 2730. More specifically, thethird clutch 6310 comprises one or more keys extending into the keyslots 6315 such that the distal ends of the key slots 6315 stop thedistal movement of the third clutch 6310 and the proximal ends of thekey slots 6315 stop the proximal movement of the third clutch 6310.

When the third clutch 6310 is in its disengaged position, referring toFIG. 32, the third clutch 6310 rotates with the drive shaft 2730 butdoes not transmit rotational motion to the third drive ring 6320. As canbe seen in FIG. 32, the third clutch 6310 is separated from, or not incontact with, the third drive ring 6320. As a result, the rotation ofthe drive shaft 2730 and the third clutch 6310 is not transmitted to thearticulation drive 6330 when the third clutch assembly 6300 is in itsdisengaged state. When the third clutch 6310 is in its engaged position,referring to FIG. 33, the third clutch 6310 is engaged with the thirddrive ring 6320 such that the third drive ring 6320 is expanded, orstretched, radially outwardly into contact with the articulation drive6330. In at least one instance, the third drive ring 6320 comprises anelastomeric band, for example. As can be seen in FIG. 33, the thirddrive ring 6320 is compressed against an annular inner sidewall 6335 ofthe articulation drive 6330. As a result, the rotation of the driveshaft 2730 and the third clutch 6310 is transmitted to the articulationdrive 6330 when the third clutch assembly 6300 is in its engaged state.Depending on the direction in which the drive shaft 2730 is rotated, thethird clutch assembly 6300 can articulate the distal attachment portion2400 of the shaft assembly 2000 and the end effector 7000 in a first orsecond direction about the articulation joint 2300.

As described above, the third electromagnetic actuator 6340 isconfigured to generate magnetic fields to move the third clutch 6310between its disengaged (FIG. 32) and engaged (FIG. 33) positions. Forinstance, referring to FIG. 32, the third electromagnetic actuator 6340is configured to emit a magnetic field EF_(L) which repulses, or drives,the third clutch 6310 away from the third drive ring 6320 when the thirdclutch assembly 6300 is in its disengaged state. The thirdelectromagnetic actuator 6340 comprises one or more wound coils in acavity defined in the shaft frame 2530 which generate the magnetic fieldEF_(L) when current flows in a first direction through a thirdelectrical clutch circuit including the wound coils. The control system1800 is configured to apply a first voltage polarity to the thirdelectrical clutch circuit to create the current flowing in the firstdirection. The control system 1800 can continuously apply the firstvoltage polarity to the third electric clutch circuit to continuouslyhold the third clutch 6310 in its disengaged position. While such anarrangement can prevent the third clutch 6310 from unintentionallyengaging the third drive ring 6320, such an arrangement can also consumea lot of power. Alternatively, the control system 1800 can apply thefirst voltage polarity to the third electrical clutch circuit for asufficient period of time to position the third clutch 6310 in itsdisengaged position and then discontinue applying the first voltagepolarity to the third electric clutch circuit, thereby resulting in alower consumption of power.

Further to the above, the third electromagnetic actuator 6340 isconfigured to emit a magnetic field EF_(D) which pulls, or drives, thethird clutch 6310 toward the third drive ring 6320 when the third clutchassembly 6300 is in its engaged state. The coils of the thirdelectromagnetic actuator 6340 generate the magnetic field EF_(D) whencurrent flows in a second, or opposite, direction through the thirdelectrical clutch circuit. The control system 1800 is configured toapply an opposite voltage polarity to the third electrical shaft circuitto create the current flowing in the opposite direction. The controlsystem 1800 can continuously apply the opposite voltage polarity to thethird electric shaft circuit to continuously hold the third clutch 6310in its engaged position and maintain the operable engagement between thethird drive ring 6320 and the articulation drive 6330. Alternatively,the third clutch 6210 can be configured to become wedged within thethird drive ring 6320 when the third clutch 6310 is in its engagedposition and, in such instances, the control system 1800 may not need tocontinuously apply a voltage polarity to the third shaft electricalcircuit to hold the third clutch assembly 6300 in its engaged state. Insuch instances, the control system 1800 can discontinue applying thevoltage polarity once the third clutch 6310 has been sufficiently wedgedin the third drive ring 6320. In any event, the end effector 7000 isarticulatable in a first direction or a second direction, depending onthe direction in which the drive shaft 2730 is rotated, when the thirdclutch assembly 6300 is in its engaged state.

Further to the above, referring to FIGS. 22, 32, and 33, thearticulation drive system further comprises a lockout 6350 whichprevents, or at least inhibits, the articulation of the distalattachment portion 2400 of the shaft assembly 2000 and the end effector7000 about the articulation joint 2300 when the third clutch 6310 is inits disengaged position (FIG. 32). Referring primarily to FIG. 22, thearticulation link 2340 comprises a slot, or groove, 2350 defined thereinwherein the lockout 6350 is slideably positioned in the slot 2350 andextends at least partially under the stationary articulation gear 2330.The lockout 6350 comprises at attachment hook 6352 engaged with thethird clutch 6310. More specifically, the third clutch 6310 comprises anannular slot, or groove, 6312 defined therein and the attachment hook6352 is positioned in the annular slot 6312 such that the lockout 6350translates with the third clutch 6310. Notably, however, the lockout6350 does not rotate, or at least substantially rotate, with the thirdclutch 6310. Instead, the annular groove 6312 in the third clutch 6310permits the third clutch 6310 to rotate relative to the lockout 6350.The lockout 6350 further comprises a lockout hook 6354 slideablypositioned in a radially-extending lockout slot 2334 defined in thebottom of the stationary gear 2330. When the third clutch 6310 is in itsdisengaged position, as illustrated in FIG. 32, the lockout 6350 is in alocked position in which the lockout hook 6354 prevents the end effector7000 from rotating about the articulation joint 2300. When the thirdclutch 6310 is in its engaged position, as illustrated in FIG. 33, thelockout 6350 is in an unlocked position in which the lockout hook 6354is no longer positioned in the lockout slot 2334. Instead, the lockouthook 6354 is positioned in a clearance slot defined in the middle orbody 2335 of the stationary gear 2330. In such instances, the lockouthook 6354 can rotate within the clearance slot when the end effector7000 rotates about the articulation joint 2300.

Further to the above, the radially-extending lockout slot 2334 depictedin FIGS. 32 and 33 extends longitudinally, i.e., along an axis which isparallel to the longitudinal axis of the elongate shaft 2200. Once theend effector 7000 has been articulated, however, the lockout hook 6354is no longer aligned with the longitudinal lockout slot 2334. With thisin mind, the stationary gear 2330 comprises a plurality, or an array, ofradially-extending lockout slots 2334 defined in the bottom of thestationary gear 2330 such that, when the third clutch 6310 is deactuatedand the lockout 6350 is pulled distally after the end effector 7000 hasbeen articulated, the lockout hook 6354 can enter one of the lockoutslots 2334 and lock the end effector 7000 in its articulated position.Thus, as a result, the end effector 7000 can be locked in anunarticulated and an articulated position. In various instances, thelockout slots 2334 can define discrete articulated positions for the endeffector 7000. For instance, the lockout slots 2334 can be defined at 10degree intervals, for example, which can define discrete articulationorientations for the end effector 7000 at 10 degree intervals. In otherinstances, these orientations can be at 5 degree intervals, for example.In alternative embodiments, the lockout 6350 comprises a brake thatengages a circumferential shoulder defined in the stationary gear 2330when the third clutch 6310 is disengaged from the third drive ring 6320.In such an embodiment, the end effector 7000 can be locked in anysuitable orientation. In any event, the lockout 6350 prevents, or atleast reduces the possibility of, the end effector 7000 unintentionallyarticulating. As a result of the above, the third clutch 6310 can dothings—operate the articulation drive when it is in its engaged positionand lock out the articulation drive when it is in its disengagedposition.

Referring primarily to FIGS. 24 and 25, the shaft frame 2530 and thedrive shaft 2730 extend through the articulation joint 2300 into thedistal attachment portion 2400. When the end effector 7000 isarticulated, as illustrated in FIGS. 16 and 17, the shaft frame 2530 andthe drive shaft 2730 bend to accommodate the articulation of the endeffector 7000. Thus, the shaft frame 2530 and the drive shaft 2730 arecomprised of any suitable material which accommodates the articulationof the end effector 7000. Moreover, as discussed above, the shaft frame2530 houses the first, second, and third electromagnetic actuators 6140,6240, and 6340. In various instances, the first, second, and thirdelectromagnetic actuators 6140, 6240, and 6340 each comprise wound wirecoils, such as copper wire coils, for example, and the shaft frame 2530is comprised of an insulative material to prevent, or at least reducethe possibility of, short circuits between the first, second, and thirdelectromagnetic actuators 6140, 6240, and 6340. In various instances,the first, second, and third electrical clutch circuits extendingthrough the shaft frame 2530 are comprised of insulated electricalwires, for example. Further to the above, the first, second, and thirdelectrical clutch circuits place the electromagnetic actuators 6140,6240, and 6340 in communication with the control system 1800 in thedrive module 1100.

As described above, the clutches 6110, 6210, and/or 6310 can be held intheir disengaged positions so that they do not unintentionally move intotheir engaged positions. In various arrangements, the clutch system 6000comprises a first biasing member, such as a spring, for example,configured to bias the first clutch 6110 into its disengaged position, asecond biasing member, such as a spring, for example, configured to biasthe second clutch 6210 into its disengaged position, and/or a thirdbiasing member, such as a spring, for example, configured to bias thethird clutch 6110 into its disengaged position. In such arrangements,the biasing forces of the springs can be selectively overcome by theelectromagnetic forces generated by the electromagnetic actuators whenenergized by an electrical current. Further to the above, the clutches6110, 6210, and/or 6310 can be retained in their engaged positions bythe drive rings 6120, 6220, and/or 6320, respectively. Morespecifically, in at least one instance, the drive rings 6120, 6220,and/or 6320 are comprised of an elastic material which grips orfrictionally holds the clutches 6110, 6210, and/or 6310, respectively,in their engaged positions. In various alternative embodiments, theclutch system 6000 comprises a first biasing member, such as a spring,for example, configured to bias the first clutch 6110 into its engagedposition, a second biasing member, such as a spring, for example,configured to bias the second clutch 6210 into its engaged position,and/or a third biasing member, such as a spring, for example, configuredto bias the third clutch 6110 into its engaged position. In sucharrangements, the biasing forces of the springs can be overcome by theelectromagnetic forces applied by the electromagnetic actuators 6140,6240, and/or 6340, respectively, as needed to selectively hold theclutches 6110, 6210, and 6310 in their disengaged positions. In any oneoperational mode of the surgical system, the control assembly 1800 canenergize one of the electromagnetic actuators to engage one of theclutches while energizing the other two electromagnetic actuators todisengage the other two clutches.

Although the clutch system 6000 comprises three clutches to controlthree drive systems of the surgical system, a clutch system can compriseany suitable number of clutches to control any suitable number ofsystems. Moreover, although the clutches of the clutch system 6000 slideproximally and distally between their engaged and disengaged positions,the clutches of a clutch system can move in any suitable manner. Inaddition, although the clutches of the clutch system 6000 are engagedone at a time to control one drive motion at a time, various instancesare envisioned in which more than one clutch can be engaged to controlmore than one drive motion at a time.

In view of the above, the reader should appreciate that the controlsystem 1800 is configured to, one, operate the motor system 1600 torotate the drive shaft system 2700 in an appropriate direction and, two,operate the clutch system 6000 to transfer the rotation of the driveshaft system 2700 to the appropriate function of the end effector 7000.Moreover, as discussed above, the control system 1800 is responsive toinputs from the clamping trigger system 2600 of the shaft assembly 2000and the input system 1400 of the handle 1000. When the clamping triggersystem 2600 is actuated, as discussed above, the control system 1800activates the first clutch assembly 6100 and deactivates the secondclutch assembly 6200 and the third clutch assembly 6300. In suchinstances, the control system 1800 also supplies power to the motorsystem 1600 to rotate the drive shaft system 2700 in a first directionto clamp the jaw assembly 7100 of the end effector 7000. When thecontrol system 1800 detects that the jaw assembly 7100 is in its clampedconfiguration, the control system 1800 stops the motor assembly 1600 anddeactivates the first clutch assembly 6100. When the control system 1800detects that the clamping trigger system 2600 has been moved to, or isbeing moved to, its unactuated position, the control system 1800activates, or maintains the activation of, the first clutch assembly6100 and deactivates, or maintains the deactivation of, the secondclutch assembly 6200 and the third clutch assembly 6300. In suchinstances, the control system 1800 also supplies power to the motorsystem 1600 to rotate the drive shaft system 2700 in a second directionto open the jaw assembly 7100 of the end effector 7000.

When the rotation actuator 1420 is actuated in a first direction,further to the above, the control system 1800 activates the secondclutch assembly 6200 and deactivates the first clutch assembly 6100 andthe third clutch assembly 6300. In such instances, the control system1800 also supplies power to the motor system 1600 to rotate the driveshaft system 2700 in a first direction to rotate the end effector 7000in a first direction. When the control system 1800 detects that therotation actuator 1420 has been actuated in a second direction, thecontrol system 1800 activates, or maintains the activation of, thesecond clutch assembly 6200 and deactivates, or maintains thedeactivation of, the first clutch assembly 6100 and the third clutchassembly 6300. In such instances, the control system 1800 also suppliespower to the motor system 1600 to rotate the drive shaft system 2700 ina second direction to rotate the drive shaft system 2700 in a seconddirection to rotate the end effector 7000 in a second direction. Whenthe control system 1800 detects that the rotation actuator 1420 is notactuated, the control system 1800 deactivates the second clutch assembly6200.

When the first articulation actuator 1432 is depressed, further to theabove, the control system 1800 activates the third clutch assembly 6300and deactivates the first clutch assembly 6100 and the second clutchassembly 6200. In such instances, the control system 1800 also suppliespower to the motor system 1600 to rotate the drive shaft system 2700 ina first direction to articulate the end effector 7000 in a firstdirection. When the control system 1800 detects that the secondarticulation actuator 1434 is depressed, the control system 1800activates, or maintains the activation of, the third clutch assembly6200 and deactivates, or maintains the deactivation of, the first clutchassembly 6100 and the second clutch assembly 6200. In such instances,the control system 1800 also supplies power to the motor system 1600 torotate the drive shaft system 2700 in a second direction to articulatethe end effector 7000 in a second direction. When the control system1800 detects that neither the first articulation actuator 1432 nor thesecond articulation actuator 1434 are actuated, the control system 1800deactivates the third clutch assembly 6200.

Further to the above, the control system 1800 is configured to changethe operating mode of the stapling system based on the inputs itreceives from the clamping trigger system 2600 of the shaft assembly2000 and the input system 1400 of the handle 1000. The control system1800 is configured to shift the clutch system 6000 before rotating theshaft drive system 2700 to perform the corresponding end effectorfunction. Moreover, the control system 1800 is configured to stop therotation of the shaft drive system 2700 before shifting the clutchsystem 6000. Such an arrangement can prevent the sudden movements in theend effector 7000. Alternatively, the control system 1800 can shift theclutch system 600 while the shaft drive system 2700 is rotating. Such anarrangement can allow the control system 1800 to shift quickly betweenoperating modes.

As discussed above, referring to FIG. 34, the distal attachment portion2400 of the shaft assembly 2000 comprises an end effector lock 6400configured to prevent the end effector 7000 from being unintentionallydecoupled from the shaft assembly 2000. The end effector lock 6400comprises a lock end 6410 selectively engageable with the annular arrayof lock notches 7410 defined on the proximal attachment portion 7400 ofthe end effector 7000, a proximal end 6420, and a pivot 6430 rotatablyconnecting the end effector lock 6400 to the articulation link 2320.When the third clutch 6310 of the third clutch assembly 6300 is in itsdisengaged position, as illustrated in FIG. 34, the third clutch 6310 iscontact with the proximal end 6420 of the end effector lock 6400 suchthat the lock end 6410 of the end effector lock 6400 is engaged with thearray of lock notches 7410. In such instances, the end effector 7000 canrotate relative to the end effector lock 6400 but cannot translaterelative to the distal attachment portion 2400. When the third clutch6310 is moved into its engaged position, as illustrated in FIG. 35, thethird clutch 6310 is no longer engaged with the proximal end 6420 of theend effector lock 6400. In such instances, the end effector lock 6400 isfree to pivot upwardly and permit the end effector 7000 to be detachedfrom the shaft assembly 2000.

The above being said, referring again to FIG. 34, it is possible thatthe second clutch 6210 of the second clutch assembly 6200 is in itsdisengaged position when the clinician detaches, or attempts to detach,the end effector 7000 from the shaft assembly 2000. As discussed above,the second clutch 6210 is engaged with the second clutch lock 6250 whenthe second clutch 6210 is in its disengaged position and, in suchinstances, the second clutch lock 6250 is pushed into engagement withthe articulation link 2340. More specifically, the second clutch lock6250 is positioned in the channel 2345 defined in the articulation 2340when the second clutch 6210 is engaged with the second clutch lock 6250which may prevent, or at least impede, the end effector 7000 from beingdetached from the shaft assembly 2000. To facilitate the release of theend effector 7000 from the shaft assembly 2000, the control system 1800can move the second clutch 6210 into its engaged position in addition tomoving the third clutch 6310 into its engaged position. In suchinstances, the end effector 7000 can clear both the end effector lock6400 and the second clutch lock 6250 when the end effector 7000 isremoved.

In at least one instance, further to the above, the drive module 1100comprises an input switch and/or sensor in communication with thecontrol system 1800 via the input system 1400, and/or the control system1800 directly, which, when actuated, causes the control system 1800 tounlock the end effector 7000. In various instances, the drive module1100 comprises an input screen 1440 in communication with the board 1410of the input system 1400 which is configured to receive an unlock inputfrom the clinician. In response to the unlock input, the control system1800 can stop the motor system 1600, if it is running, and unlock theend effector 7000 as described above. The input screen 1440 is alsoconfigured to receive a lock input from the clinician in which the inputsystem 1800 moves the second clutch assembly 6200 and/or the thirdclutch assembly 6300 into their unactuated states to lock the endeffector 7000 to the shaft assembly 2000.

FIG. 37 depicts a shaft assembly 2000′ in accordance with at least onealternative embodiment. The shaft assembly 2000′ is similar to the shaftassembly 2000 in many respects, most of which will not be repeatedherein for the sake of brevity. Similar to the shaft assembly 2000, theshaft assembly 2000′ comprises a shaft frame, i.e., shaft frame 2530′.The shaft frame 2530′ comprises a longitudinal passage 2535′ and, inaddition, a plurality of clutch position sensors, i.e., a first sensor6180′, a second sensor 6280′, and a third sensor 6380′ positioned in theshaft frame 2530′. The first sensor 6180′ is in signal communicationwith the control system 1800 as part of a first sensing circuit. Thefirst sensing circuit comprises signal wires extending through thelongitudinal passage 2535′; however, the first sensing circuit cancomprise a wireless signal transmitter and receiver to place the firstsensor 6180′ in signal communication with the control system 1800. Thefirst sensor 6180′ is positioned and arranged to detect the position ofthe first clutch 6110 of the first clutch assembly 6100. Based on datareceived from the first sensor 6180′, the control system 1800 candetermine whether the first clutch 6110 is in its engaged position, itsdisengaged position, or somewhere in-between. With this information, thecontrol system 1800 can assess whether or not the first clutch 6110 isin the correct position given the operating state of the surgicalinstrument. For instance, if the surgical instrument is in its jawclamping/opening operating state, the control system 1800 can verifywhether the first clutch 6110 is properly positioned in its engagedposition. In such instances, further to the below, the control system1800 can also verify that the second clutch 6210 is in its disengagedposition via the second sensor 6280′ and that the third clutch 6310 isin its disengaged position via the third sensor 6380′. Correspondingly,the control system 1800 can verify whether the first clutch 6110 isproperly positioned in its disengaged position if the surgicalinstrument is not in its jaw clamping/opening state. To the extent thatthe first clutch 6110 is not in its proper position, the control system1800 can actuate the first electromagnetic actuator 6140 in an attemptto properly position the first clutch 6110. Likewise, the control system1800 can actuate the electromagnetic actuators 6240 and/or 6340 toproperly position the clutches 6210 and/or 6310, if necessary.

The second sensor 6280′ is in signal communication with the controlsystem 1800 as part of a second sensing circuit. The second sensingcircuit comprises signal wires extending through the longitudinalpassage 2535′; however, the second sensing circuit can comprise awireless signal transmitter and receiver to place the second sensor6280′ in signal communication with the control system 1800. The secondsensor 6280′ is positioned and arranged to detect the position of thesecond clutch 6210 of the first clutch assembly 6200. Based on datareceived from the second sensor 6280′, the control system 1800 candetermine whether the second clutch 6210 is in its engaged position, itsdisengaged position, or somewhere in-between. With this information, thecontrol system 1800 can assess whether or not the second clutch 6210 isin the correct position given the operating state of the surgicalinstrument. For instance, if the surgical instrument is in its endeffector rotation operating state, the control system 1800 can verifywhether the second clutch 6210 is properly positioned in its engagedposition. In such instances, the control system 1800 can also verifythat the first clutch 6110 is in its disengaged position via the firstsensor 6180′ and, further to the below, the control system 1800 can alsoverify that the third clutch 6310 is in its disengaged position via thethird sensor 6380′. Correspondingly, the control system 1800 can verifywhether the second clutch 6110 is properly positioned in its disengagedposition if the surgical instrument is not in its end effector rotationstate. To the extent that the second clutch 6210 is not in its properposition, the control system 1800 can actuate the second electromagneticactuator 6240 in an attempt to properly position the second clutch 6210.Likewise, the control system 1800 can actuate the electromagneticactuators 6140 and/or 6340 to properly position the clutches 6110 and/or6310, if necessary.

The third sensor 6380′ is in signal communication with the controlsystem 1800 as part of a third sensing circuit. The third sensingcircuit comprises signal wires extending through the longitudinalpassage 2535′; however, the third sensing circuit can comprise awireless signal transmitter and receiver to place the third sensor 6380′in signal communication with the control system 1800. The third sensor6380′ is positioned and arranged to detect the position of the thirdclutch 6310 of the third clutch assembly 6300. Based on data receivedfrom the third sensor 6380′, the control system 1800 can determinewhether the third clutch 6310 is in its engaged position, its disengagedposition, or somewhere in-between. With this information, the controlsystem 1800 can assess whether or not the third clutch 6310 is in thecorrect position given the operating state of the surgical instrument.For instance, if the surgical instrument is in its end effectorarticulation operating state, the control system 1800 can verify whetherthe third clutch 6310 is properly positioned in its engaged position. Insuch instances, the control system 1800 can also verify that the firstclutch 6110 is in its disengaged position via the first sensor 6180′ andthat the second clutch 6210 is in its disengaged position via the secondsensor 6280′. Correspondingly, the control system 1800 can verifywhether the third clutch 6310 is properly positioned in its disengagedposition if the surgical instrument is not in its end effectorarticulation state. To the extent that the third clutch 6310 is not inits proper position, the control system 1800 can actuate the thirdelectromagnetic actuator 6340 in an attempt to properly position thethird clutch 6310. Likewise, the control system 1800 can actuate theelectromagnetic actuators 6140 and/or 6240 to properly position theclutches 6110 and/or 6210, if necessary.

Further to the above, the clutch position sensors, i.e., the firstsensor 6180′, the second sensor 6280′, and the third sensor 6380′ cancomprise any suitable type of sensor. In various instances, the firstsensor 6180′, the second sensor 6280′, and the third sensor 6380′ eachcomprise a proximity sensor. In such an arrangement, the sensors 6180′,6280′, and 6380′ are configured to detect whether or not the clutches6110, 6210, and 6310, respectively, are in their engaged positions. Invarious instances, the first sensor 6180′, the second sensor 6280′, andthe third sensor 6380′ each comprise a Hall Effect sensor, for example.In such an arrangement, the sensors 6180′, 6280′, and 6380′ can not onlydetect whether or not the clutches 6110, 6210, and 6310, respectively,are in their engaged positions but the sensors 6180′, 6280′, and 6380′can also detect how close the clutches 6110, 6210, and 6310 are withrespect to their engaged or disengaged positions.

FIG. 38 depicts the shaft assembly 2000′ and an end effector 7000″ inaccordance with at least one alternative embodiment. The end effector7000″ is similar to the end effector 7000 in many respects, most ofwhich will not be repeated herein for the sake of brevity. Similar tothe end effector 7000, the shaft assembly 7000″ comprises a jaw assembly7100 and a jaw assembly drive configured to move the jaw assembly 7100between its open and closed configurations. The jaw assembly drivecomprises drive links 7140, a drive nut 7150″, and a drive screw 6130″.The drive nut 7150″ comprises a sensor 7190″ positioned therein which isconfigured to detect the position of a magnetic element 6190″ positionedin the drive screw 6130″. The magnetic element 6190″ is positioned in anelongate aperture 6134″ defined in the drive screw 6130″ and cancomprise a permanent magnet and/or can be comprised of iron, nickel,and/or any suitable metal, for example. In various instances, the sensor7190″ comprises a proximity sensor, for example, which is in signalcommunication with the control system 1800. In certain instances, thesensor 7190″ comprises a Hall Effect sensor, for example, in signalcommunication with the control system 1800. In certain instances, thesensor 7190″ comprises an optical sensor, for example, and thedetectable element 6190″ comprises an optically detectable element, suchas a reflective element, for example. In either event, the sensor 7190″is configured to communicate wirelessly with the control system 1800 viaa wireless signal transmitter and receiver and/or via a wired connectionextending through the shaft frame passage 2532′, for example.

The sensor 7190″, further to the above, is configured to detect when themagnetic element 6190″ is adjacent to the sensor 7190″ such that thecontrol system 1800 can use this data to determine that the jaw assembly7100 has reached the end of its clamping stroke. At such point, thecontrol system 1800 can stop the motor assembly 1600. The sensor 7190″and the control system 1800 are also configured to determine thedistance between where the drive screw 6130″ is currently positioned andwhere the drive screw 6130″ should be positioned at the end of itsclosure stroke in order to calculate the amount of closure stroke of thedrive screw 6130″ that is still needed to close the jaw assembly 7100.Moreover, such information can be used by the control system 1800 toassess the current configuration of the jaw assembly 7100, i.e., whetherthe jaw assembly 7100 is in its open configuration, its closedconfiguration, or a partially closed configuration. The sensor systemcould be used to determine when the jaw assembly 7100 has reached itsfully open position and stop the motor assembly 1600 at that point. Invarious instances, the control system 1800 could use this sensor systemto confirm that the first clutch assembly 6100 is in its actuated stateby confirming that the jaw assembly 7100 is moving while the motorassembly 1600 is turning. Similarly, the control system 1800 could usethis sensor system to confirm that the first clutch assembly 6100 is inits unactuated state by confirming that the jaw assembly 7100 is notmoving while the motor assembly 1600 is turning.

FIG. 39 depicts a shaft assembly 2000′″ and an end effector 7000′″ inaccordance with at least one alternative embodiment. The shaft assembly2000′″ is similar to the shaft assemblies 2000 and 2000′ in manyrespects, most of which will not be repeated herein for the sake ofbrevity. The end effector 7000′″ is similar to the end effectors 7000and 7000″ in many respects, most of which will not be repeated hereinfor the sake of brevity. Similar to the end effector 7000, the endeffector 7000′″ comprises a jaw assembly 7100 and a jaw assembly driveconfigured to move the jaw assembly 7100 between its open and closedconfigurations and, in addition, an end effector rotation drive thatrotates the end effector 7000′″ relative to the distal attachmentportion 2400 of the shaft assembly 2000′. The end effector rotationdrive comprises an outer housing 6230′″ that is rotated relative to ashaft frame 2530′″ of the end effector 7000′″ by the second clutchassembly 6200. The shaft frame 2530′″ comprises a sensor 6290′″positioned therein which is configured to detect the position of amagnetic element 6190′″ positioned in and/or on the outer housing6230′″. The magnetic element 6190′″ can comprise a permanent magnetand/or can be comprised of iron, nickel, and/or any suitable metal, forexample. In various instances, the sensor 6290′″ comprises a proximitysensor, for example, in signal communication with the control system1800. In certain instances, the sensor 6290′″ comprises a Hall Effectsensor, for example, in signal communication with the control system1800. In either event, the sensor 6290′″ is configured to communicatewirelessly with the control system 1800 via a wireless signaltransmitter and receiver and/or via a wired connection extending throughthe shaft frame passage 2532′, for example. In various instances, thecontrol system 1800 can use the sensor 6290′″ to confirm whether themagnetic element 6190′″ is rotating and, thus, confirm that the secondclutch assembly 6200 is in its actuated state. Similarly, the controlsystem 1800 can use the sensor 6290′″ to confirm whether the magneticelement 6190′″ is not rotating and, thus, confirm that the second clutchassembly 6200 is in its unactuated state. The control system 1800 canalso use the sensor 6290′″ to confirm that the second clutch assembly6200 is in its unactuated state by confirming that the second clutch6210 is positioned adjacent the sensor 6290′″.

FIG. 40 depicts a shaft assembly 2000″″ in accordance with at least onealternative embodiment. The shaft assembly 2000″″ is similar to theshaft assemblies 2000, 2000′, and 2000′″ in many respects, most of whichwill not be repeated herein for the sake of brevity. Similar to theshaft assembly 2000, the shaft assembly 2000″″ comprises, among otherthings, an elongate shaft 2200, an articulation joint 2300, and a distalattachment portion 2400 configured to receive an end effector, such asend effector 7000′, for example. Similar to the shaft assembly 2000, theshaft assembly 2000″″ comprises an articulation drive, i.e.,articulation drive 6330″″ configured to rotate the distal attachmentportion 2400 and the end effector 7000′ about the articulation joint2300. Similar to the above, a shaft frame 2530″″ comprises a sensorpositioned therein configured to detect the position, and/or rotation,of a magnetic element 6390″″ positioned in and/or on the articulationdrive 6330″″. The magnetic element 6390″″ can comprise a permanentmagnet and/or can be comprised of iron, nickel, and/or any suitablemetal, for example. In various instances, the sensor comprises aproximity sensor, for example, in signal communication with the controlsystem 1800. In certain instances, the sensor comprises a Hall Effectsensor, for example, in signal communication with the control system1800. In either event, the sensor is configured to communicatewirelessly with the control system 1800 via a wireless signaltransmitter and receiver and/or via a wired connection extending throughthe shaft frame passage 2532′, for example. In various instances, thecontrol system 1800 can use the sensor to confirm whether the magneticelement 6390″″ is rotating and, thus, confirm that the third clutchassembly 6300 is in its actuated state. Similarly, the control system1800 can use the sensor to confirm whether the magnetic element 6390″″is not rotating and, thus, confirm that the third clutch assembly 6300is in its unactuated state. In certain instances, the control system1800 can use the sensor to confirm that the third clutch assembly 6300is in its unactuated state by confirming that the third clutch 6310 ispositioned adjacent the sensor.

Referring to FIG. 40 once again, the shaft assembly 2000″″ comprises anend effector lock 6400′ configured to releasably lock the end effector7000′, for example, to the shaft assembly 2000″″. The end effector lock6400′ is similar to the end effector lock 6400 in many respects, most ofwhich will not be discussed herein for the sake of brevity. Notably,though, a proximal end 6420′ of the lock 6400′ comprises a tooth 6422′configured to engage the annular slot 6312 of the third clutch 6310 andreleasably hold the third clutch 6310 in its disengaged position. Thatsaid, the actuation of the third electromagnetic assembly 6340 candisengage the third clutch 6310 from the end effector lock 6400′.Moreover, in such instances, the proximal movement of the third clutch6310 into its engaged position rotates the end effector lock 6400′ intoa locked position and into engagement with the lock notches 7410 to lockthe end effector 7000′ to the shaft assembly 2000″″. Correspondingly,the distal movement of the third clutch 6310 into its disengagedposition unlocks the end effector 7000′ and allows the end effector7000′ to be disassembled from the shaft assembly 2000″″.

Further to the above, an instrument system including a handle and ashaft assembly attached thereto can be configured to perform adiagnostic check to assess the state of the clutch assemblies 6100,6200, and 6300. In at least one instance, the control system 1800sequentially actuates the electromagnetic actuators 6140, 6240, and/or6340—in any suitable order—to verify the positions of the clutches 6110,6210, and/or 6310, respectively, and/or verify that the clutches areresponsive to the electromagnetic actuators and, thus, not stuck. Thecontrol system 1800 can use sensors, including any of the sensorsdisclosed herein, to verify the movement of the clutches 6110, 6120, and6130 in response to the electromagnetic fields created by theelectromagnetic actuators 6140, 6240, and/or 6340. In addition, thediagnostic check can also include verifying the motions of the drivesystems. In at least one instance, the control system 1800 sequentiallyactuates the electromagnetic actuators 6140, 6240, and/or 6340—in anysuitable order—to verify that the jaw drive opens and/or closes the jawassembly 7100, the rotation drive rotates the end effector 7000, and/orthe articulation drive articulates the end effector 7000, for example.The control system 1800 can use sensors to verify the motions of the jawassembly 7100 and end effector 7000.

The control system 1800 can perform the diagnostic test at any suitabletime, such as when a shaft assembly is attached to the handle and/orwhen the handle is powered on, for example. If the control system 1800determines that the instrument system passed the diagnostic test, thecontrol system 1800 can permit the ordinary operation of the instrumentsystem. In at least one instance, the handle can comprise an indicator,such as a green LED, for example, which indicates that the diagnosticcheck has been passed. If the control system 1800 determines that theinstrument system failed the diagnostic test, the control system 1800can prevent and/or modify the operation of the instrument system. In atleast one instance, the control system 1800 can limit the functionalityof the instrument system to only the functions necessary to remove theinstrument system from the patient, such as straightening the endeffector 7000 and/or opening and closing the jaw assembly 7100, forexample. In at least one respect, the control system 1800 enters into alimp mode. The limp mode of the control system 1800 can reduce a currentrotational speed of the motor 1610 by any percentage selected from arange of about 75% to about 25%, for example. In one example, the limpmode reduces a current rotational speed of the motor 1610 by 50%. In oneexample, the limp mode reduces the current rotational speed of the motor1610 by 75%. The limp mode may cause a current torque of the motor 1610to be reduced by any percentage selected from a range of about 75% toabout 25%, for example. In one example, the limp mode reduces a currenttorque of the motor 1610 by 50%. The handle can comprise an indicator,such as a red LED, for example, which indicates that the instrumentsystem failed the diagnostic check and/or that the instrument system hasentered into a limp mode. The above being said, any suitable feedbackcan be used to warn the clinician that the instrument system is notoperating properly such as, for example, an audible warning and/or atactile or vibratory warning, for example.

FIGS. 41-43 depict a clutch system 6000′ in accordance with at least onealternative embodiment. The clutch system 6000′ is similar to the clutchsystem 6000 in many respects, most of which will not be repeated hereinfor the sake of brevity. Similar to the clutch system 6000, the clutchsystem 6000′ comprises a clutch assembly 6100′ which is actuatable toselectively couple a rotatable drive input 6030′ with a rotatable driveoutput 6130′. The clutch assembly 6100′ comprises clutch plates 6110′and drive rings 6120′. The clutch plates 6110′ are comprised of amagnetic material, such as iron and/or nickel, for example, and cancomprise a permanent magnet. As described in greater detail below, theclutch plates 6110′ are movable between unactuated positions (FIG. 42)and actuated positions (FIG. 43) within the drive output 6130′. Theclutch plates 6110′ are slideably positioned in apertures defined in thedrive output 6130′ such that the clutch plates 6110′ rotate with thedrive output 6130′ regardless of whether the clutch plates 6110′ are intheir unactuated or actuated positions.

When the clutch plates 6110′ are in their unactuated positions, asillustrated in FIG. 42, the rotation of the drive input 6030′ is nottransferred to the drive output 6130′. More specifically, when the driveinput 6030′ is rotated, in such instances, the drive input 6030′ slidespast and rotates relative to the drive rings 6120′ and, as a result, thedrive rings 6120′ do not drive the clutch plates 6110′ and the driveoutput 6130′. When the clutch plates 6110′ are in their actuatedpositions, as illustrated in FIG. 43, the clutch plates 6110′resiliently compress the drive rings 6120′ against the drive input6030′. The drive rings 6120′ are comprised of any suitable compressiblematerial, such as rubber, for example. In any event, in such instances,the rotation of the drive input 6030′ is transferred to the drive output6130′ via the drive rings 6120′ and the clutch plates 6110′. The clutchsystem 6000′ comprises a clutch actuator 6140′ configured to move theclutch plates 6110′ into their actuated positions. The clutch actuator6140′ is comprised of a magnetic material such as iron and/or nickel,for example, and can comprise a permanent magnet. The clutch actuator6140′ is slideably positioned in a longitudinal shaft frame 6050′extending through the drive input 6030′ and can be moved between anunactuated position (FIG. 42) and an actuated position (FIG. 43) by aclutch shaft 6060′. In at least one instance, the clutch shaft 6060′comprises a polymer cable, for example. When the clutch actuator 6140′is in its actuated position, as illustrated in FIG. 43, the clutchactuator 6140′ pulls the clutch plates 6110′ inwardly to compress thedrive rings 6120′, as discussed above. When the clutch actuator 6140′ ismoved into its unactuated position, as illustrated in FIG. 42, the driverings 6120′ resiliently expand and push the clutch plates 6110′ awayfrom the drive input 6030′. In various alternative embodiments, theclutch actuator 6140′ can comprise an electromagnet. In such anarrangement, the clutch actuator 6140′ can be actuated by an electricalcircuit extending through a longitudinal aperture defined in the clutchshaft 6060′, for example. In various instances, the clutch system 6000′further comprises electrical wires 6040′, for example, extending throughthe longitudinal aperture.

FIG. 44 depicts an end effector 7000 a including a jaw assembly 7100 a,a jaw assembly drive, and a clutch system 6000 a in accordance with atleast one alternative embodiment. The jaw assembly 7100 a comprises afirst jaw 7110 a and a second jaw 7120 a which are selectively rotatableabout a pivot 7130 a. The jaw assembly drive comprises a translatableactuator rod 7160 a and drive links 7140 a which are pivotably coupledto the actuator rod 7160 a about a pivot 7150 a. The drive links 7140 aare also pivotably coupled to the jaws 7110 a and 7120 a such that thejaws 7110 a and 7120 a are rotated closed when the actuator rod 7160 ais pulled proximally and rotated open when the actuator rod 7160 a ispushed distally. The clutch system 6000 a is similar to the clutchsystems 6000 and 6000′ in many respects, most of which will not berepeated herein for the sake of brevity. The clutch system 6000 acomprises a first clutch assembly 6100 a and a second clutch assembly6200 a which are configured to selectively transmit the rotation of adrive input 6030 a to rotate the jaw assembly 7100 a about alongitudinal axis and articulate the jaw assembly 7100 a about anarticulation joint 7300 a, respectively, as described in greater detailbelow.

The first clutch assembly 6100 a comprises clutch plates 6110 a anddrive rings 6120 a and work in a manner similar to the clutch plates6110′ and drive rings 6120′ discussed above. When the clutch pates 6110a are actuated by an electromagnetic actuator 6140 a, the rotation ofthe drive input 6030 a is transferred to an outer shaft housing 7200 a.More specifically, the outer shaft housing 7200 a comprises a proximalouter housing 7210 a and a distal outer housing 7220 a which isrotatably supported by the proximal outer housing 7210 a and is rotatedrelative to the proximal outer housing 7210 a by the drive input 6030 awhen the clutch plates 6110 a are in their actuated position. Therotation of the distal outer housing 7220 a rotates the jaw assembly7100 a about the longitudinal axis owing to fact that the pivot 7130 aof the jaw assembly 7100 a is mounted to the distal outer housing 7220a. As a result, the outer shaft housing 7200 a rotates the jaw assembly7100 a in a first direction when the outer shaft housing 7200 a isrotated in a first direction by the drive input 6030 a. Similarly, theouter shaft housing 7200 a rotates the jaw assembly 7100 a in a seconddirection when the outer shaft housing 7200 a is rotated in a seconddirection by the drive input 6030 a. When the electromagnetic actuator6140 a is de-energized, the drive rings 6120 a expand and the clutchplates 6110 a are moved into their unactuated positions, therebydecoupling the end effector rotation drive from the drive input 6030 a.

The second clutch assembly 6200 a comprises clutch plates 6210 a anddrive rings 6220 a and work in a manner similar to the clutch plates6110′ and drive rings 6120′ discussed above. When the clutch pates 6210a are actuated by an electromagnetic actuator 6240 a, the rotation ofthe drive input 6030 a is transferred to an articulation drive 6230 a.The articulation drive 6230 a is rotatably supported within an outershaft housing 7410 a of an end effector attachment portion 7400 a and isrotatably supported by a shaft frame 6050 a extending through the outershaft housing 7410 a. The articulation drive 6230 a comprises a gearface defined thereon which is operably intermeshed with a stationarygear face 7230 a defined on the proximal outer housing 7210 a of theouter shaft housing 7200 a. As a result, the articulation drive 6230 aarticulates the outer shaft housing 7200 a and the jaw assembly 7100 ain a first direction when the articulation drive 6230 a is rotated in afirst direction by the drive input 6030 a. Similarly, the articulationdrive 6230 a articulates the outer shaft housing 7200 a and the jawassembly 7100 a in a second direction when the articulation drive 6230 ais rotated in a second direction by the drive input 6030 a. When theelectromagnetic actuator 6240 a is de-energized, the drive rings 6220 aexpand and the clutch plates 6210 a are moved into their unactuatedpositions, thereby decoupling the end effector articulation drive fromthe drive input 6030 a.

Further to the above, the shaft assembly 4000 is illustrated in FIGS.45-49. The shaft assembly 4000 is similar to the shaft assemblies 2000,2000′, 2000′″, and 2000″″ in many respects, most of which will not berepeated herein for the sake of brevity. The shaft assembly 4000comprises a proximal portion 4100, an elongate shaft 4200, a distalattachment portion 2400, and an articulate joint 2300 which rotatablyconnects the distal attachment portion 2040 to the elongate shaft 4200.The proximal portion 4100, similar to the proximal portion 2100, isoperably attachable to the drive module 1100 of the handle 1000. Theproximal portion 4100 comprises a housing 4110 including an attachmentinterface 4130 configured to mount the shaft assembly 4000 to theattachment interface 1130 of the handle 1000. The shaft assembly 4000further comprises a frame 4500 including a shaft 4510 configured to becoupled to the shaft 1510 of the handle frame 1500 when the shaftassembly 4000 is attached to the handle 1000. The shaft assembly 4000also comprises a drive system 4700 including a rotatable drive shaft4710 configured to be operably coupled to the drive shaft 1710 of thehandle drive system 1700 when the shaft assembly 4000 is attached to thehandle 1000. The distal attachment portion 2400 is configured to receivean end effector, such as end effector 8000, for example. The endeffector 8000 is similar to the end effector 7000 in many respects, mostof which will not be repeated herein for the sake of brevity. That said,the end effector 8000 comprises a jaw assembly 8100 configured to, amongother things, grasp tissue.

As discussed above, referring primarily to FIGS. 47-49, the frame 4500of the shaft assembly 4000 comprises a frame shaft 4510. The frame shaft4510 comprises a notch, or cut-out, 4530 defined therein. As discussedin greater detail below, the cut-out 4530 is configured to provideclearance for a jaw closure actuation system 4600. The frame 4500further comprises a distal portion 4550 and a bridge 4540 connecting thedistal portion 4550 to the frame shaft 4510. The frame 4500 furthercomprises a longitudinal portion 4560 extending through the elongateshaft 4200 to the distal attachment portion 2400. Similar to the above,the frame shaft 4510 comprises one or more electrical traces definedthereon and/or therein. The electrical traces extend through thelongitudinal portion 4560, the distal portion 4550, the bridge 4540,and/or any suitable portion of the frame shaft 4510 to the electricalcontacts 2520. Referring primarily to FIG. 48, the distal portion 4550and longitudinal portion 4560 comprise a longitudinal aperture definedtherein which is configured to receive a rod 4660 of the jaw closureactuation system 4600, as described in greater detail below.

As also discussed above, referring primarily to FIGS. 48 and 49, thedrive system 4700 of the shaft assembly 4000 comprises a drive shaft4710. The drive shaft 4710 is rotatably supported within the proximalshaft housing 4110 by the frame shaft 4510 and is rotatable about alongitudinal axis extending through the frame shaft 4510. The drivesystem 4700 further comprises a transfer shaft 4750 and an output shaft4780. The transfer shaft 4750 is also rotatably supported within theproximal shaft housing 4110 and is rotatable about a longitudinal axisextending parallel to, or at least substantially parallel to, the frameshaft 4510 and the longitudinal axis defined therethrough. The transfershaft 4750 comprises a proximal spur gear 4740 fixedly mounted theretosuch that the proximal spur gear 4740 rotates with the transfer shaft4750. The proximal spur gear 4740 is operably intermeshed with anannular gear face 4730 defined around the outer circumference of thedrive shaft 4710 such that the rotation of the drive shaft 4710 istransferred to the transfer shaft 4750. The transfer shaft 4750 furthercomprises a distal spur gear 4760 fixedly mounted thereto such that thedistal spur gear 4760 rotates with the transfer shaft 4750. The distalspur gear 4760 is operably intermeshed with an annular gear 4770 definedaround the outer circumference of the output shaft 4780 such that therotation of the transfer shaft 4750 is transferred to the output shaft4780. Similar to the above, the output shaft 4780 is rotatably supportedwithin the proximal shaft housing 4110 by the distal portion 4550 of theshaft frame 4500 such that the output shaft 4780 rotates about thelongitudinal shaft axis. Notably, the output shaft 4780 is not directlycoupled to the input shaft 4710; rather, the output shaft 4780 isoperably coupled to the input shaft 4710 by the transfer shaft 4750.Such an arrangement provides room for the manually-actuated jaw closureactuation system 4600 discussed below.

Further to the above, referring primarily to FIGS. 47 and 48, the jawclosure actuation system 4600 comprises an actuation, or scissors,trigger 4610 rotatably coupled to the proximal shaft housing 4110 abouta pivot 4620. The actuation trigger 4610 comprises an elongate portion4612, a proximal end 4614, and a grip ring aperture 4616 defined in theproximal end 4614 which is configured to be gripped by the clinician.The shaft assembly 4000 further comprises a stationary grip 4160extending from the proximal housing 4110. The stationary grip 4160comprises an elongate portion 4162, a proximal end 4164, and a grip ringaperture 4166 defined in the proximal end 4164 which is configured to begripped by the clinician. In use, as described in greater detail below,the actuation trigger 4610 is rotatable between an unactuated positionand an actuated position (FIG. 48), i.e., toward the stationary grip4160, to close the jaw assembly 8100 of the end effector 8000.

Referring primarily to FIG. 48, the jaw closure actuation system 4600further comprises a drive link 4640 rotatably coupled to the proximalshaft housing 4110 about a pivot 4650 and, in addition, an actuation rod4660 operably coupled to the drive link 4640. The actuation rod 4660extends through an aperture defined in the longitudinal frame portion4560 and is translatable along the longitudinal axis of the shaft frame4500. The actuation rod 4660 comprises a distal end operably coupled tothe jaw assembly 8100 and a proximal end 4665 positioned in a drive slot4645 defined in the drive link 4640 such that the actuation rod 4660 istranslated longitudinally when the drive link 4640 is rotated about thepivot 4650. Notably, the proximal end 4665 is rotatably supported withinthe drive slot 4645 such that the actuation rod 4660 can rotate with theend effector 8000.

Further to the above, the actuation trigger 4610 further comprises adrive arm 4615 configured to engage and rotate the drive link 4640proximally, and translate the actuation rod 4660 proximally, when theactuation trigger 4610 is actuated, i.e., moved closer to the proximalshaft housing 4110. In such instances, the proximal rotation of thedrive link 4640 resiliently compresses a biasing member, such as a coilspring 4670, for example, positioned intermediate the drive link 4640and the frame shaft 4510. When the actuation trigger 4610 is released,the compressed coil spring 4670 re-expands and pushes the drive link4640 and the actuation rod 4660 distally to open the jaw assembly 8100of the end effector 8000. Moreover, the distal rotation of the drivelink 4640 drives, and automatically rotates, the actuation trigger 4610back into its unactuated position. That being said, the clinician couldmanually return the actuation trigger 4610 back into its unactuatedposition. In such instances, the actuation trigger 4610 could be openedslowly. In either event, the shaft assembly 4000 further comprises alock configured to releasably hold the actuation trigger 4610 in itsactuated position such that the clinician can use their hand to performanother task without the jaw assembly 8100 opening unintentionally.

In various alternative embodiments, further to the above, the actuationrod 4660 can be pushed distally to close the jaw assembly 8100. In atleast one such instance, the actuation rod 4660 is mounted directly tothe actuation trigger 4610 such that, when the actuation trigger 4610 isactuated, the actuation trigger 4610 drives the actuation rod 4660distally. Similar to the above, the actuation trigger 4610 can compressa spring when the actuation trigger 4610 is closed such that, when theactuation trigger 4610 is released, the actuation rod 4660 is pushedproximally.

Further to the above, the shaft assembly 4000 has threefunctions—opening/closing the jaw assembly of an end effector, rotatingthe end effector about a longitudinal axis, and articulating the endeffector about an articulation axis. The end effector rotation andarticulation functions of the shaft assembly 4000 are driven by themotor assembly 1600 and the control system 1800 of the drive module 1100while the jaw actuation function is manually-driven by the jaw closureactuation system 4600. The jaw closure actuation system 4600 could be amotor-driven system but, instead, the jaw closure actuation system 4600has been kept a manually-driven system such that the clinician can havea better feel for the tissue being clamped within the end effector.While motorizing the end effector rotation and actuation systemsprovides certain advantages for controlling the position of the endeffector, motorizing the jaw closure actuation system 4600 may cause theclinician to lose a tactile sense of the force being applied to thetissue and may not be able to assess whether the force is insufficientor excessive. Thus, the jaw closure actuation system 4600 ismanually-driven even though the end effector rotation and articulationsystems are motor-driven.

FIG. 50 is a logic diagram of the control system 1800 of the surgicalsystem depicted in FIG. 1 in accordance with at least one embodiment.The control system 1800 comprises a control circuit. The control circuitincludes a microcontroller 1840 comprising a processor 1820 and a memory1830. One or more sensors, such as sensors 1880, 1890, 6180′, 6280′,6380′, 7190″, and/or 6290′″, for example, provide real time feedback tothe processor 1820. The control system 1800 further comprises a motordriver 1850 configured to control the electric motor 1610 and a trackingsystem 1860 configured to determine the position of one or morelongitudinally movable components in the surgical instrument, such asthe clutches 6110, 6120, and 6130 and/or the longitudinally-movabledrive nut 7150 of the jaw assembly drive, for example. The trackingsystem 1860 is also configured to determine the position of one or morerotational components in the surgical instrument, such as the driveshaft 2530, the outer shaft 6230, and/or the articulation drive 6330,for example. The tracking system 1860 provides position information tothe processor 1820, which can be programmed or configured to, amongother things, determine the position of the clutches 6110, 6120, and6130 and the drive nut 7150 as well as the orientation of the jaws 7110and 7120. The motor driver 1850 may be an A3941 available from AllegroMicrosystems, Inc., for example; however, other motor drivers may bereadily substituted for use in the tracking system 1860. A detaileddescription of an absolute positioning system is described in U.S.Patent Application Publication No. 2017/0296213, entitled SYSTEMS ANDMETHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, theentire disclosure of which is hereby incorporated herein by reference.

The microcontroller 1840 may be any single core or multicore processorsuch as those known under the trade name ARM Cortex by TexasInstruments, for example. In at least one instance, the microcontroller1840 is a LM4F230H5QR ARM Cortex-M4F Processor Core, available fromTexas Instruments, for example, comprising on-chip memory of 256 KBsingle-cycle flash memory, or other non-volatile memory, up to 40 MHz, aprefetch buffer to improve performance above 40 MHz, a 32 KBsingle-cycle serial random access memory (SRAM), internal read-onlymemory (ROM) loaded with StellarisWare® software, 2 KB electricallyerasable programmable read-only memory (EEPROM), one or more pulse widthmodulation (PWM) modules and/or frequency modulation (FM) modules, oneor more quadrature encoder inputs (QEI) analog, one or more 12-bitAnalog-to-Digital Converters (ADC) with 12 analog input channels, forexample, details of which are available from the product datasheet.

In various instances, the microcontroller 1840 comprises a safetycontroller comprising two controller-based families such as TMS570 andRM4x known under the trade name Hercules ARM Cortex R4, also by TexasInstruments. The safety controller may be configured specifically forIEC 61508 and ISO 26262 safety critical applications, among others, toprovide advanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The microcontroller 1840 is programmed to perform various functions suchas precisely controlling the speed and/or position of the drive nut 7150of the jaw closure assembly, for example. The microcontroller 1840 isalso programmed to precisely control the rotational speed and positionof the end effector 7000 and the articulation speed and position of theend effector 7000. In various instances, the microcontroller 1840computes a response in the software of the microcontroller 1840. Thecomputed response is compared to a measured response of the actualsystem to obtain an “observed” response, which is used for actualfeedback decisions. The observed response is a favorable, tuned, valuethat balances the smooth, continuous nature of the simulated responsewith the measured response, which can detect outside influences on thesystem.

The motor 1610 is controlled by the motor driver 1850. In various forms,the motor 1610 is a DC brushed driving motor having a maximum rotationalspeed of approximately 25,000 RPM, for example. In other arrangements,the motor 1610 includes a brushless motor, a cordless motor, asynchronous motor, a stepper motor, or any other suitable electricmotor. The motor driver 1850 may comprise an H-bridge driver comprisingfield-effect transistors (FETs), for example. The motor driver 1850 maybe an A3941 available from Allegro Microsystems, Inc., for example. TheA3941 driver 1850 is a full-bridge controller for use with externalN-channel power metal oxide semiconductor field effect transistors(MOSFETs) specifically designed for inductive loads, such as brush DCmotors. In various instances, the driver 1850 comprises a unique chargepump regulator provides full (>10 V) gate drive for battery voltagesdown to 7 V and allows the A3941 to operate with a reduced gate drive,down to 5.5 V. A bootstrap capacitor may be employed to provide theabove-battery supply voltage required for N-channel MOSFETs. An internalcharge pump for the high-side drive allows DC (100% duty cycle)operation. The full bridge can be driven in fast or slow decay modesusing diode or synchronous rectification. In the slow decay mode,current recirculation can be through the high-side or the lowside FETs.The power FETs are protected from shoot-through by resistor adjustabledead time. Integrated diagnostics provide indication of undervoltage,overtemperature, and power bridge faults, and can be configured toprotect the power MOSFETs under most short circuit conditions. Othermotor drivers may be readily substituted.

The tracking system 1860 comprises a controlled motor drive circuitarrangement comprising one or more position sensors, such as sensors1880, 1890, 6180′, 6280′, 6380′, 7190″, and/or 6290′″, for example. Theposition sensors for an absolute positioning system provide a uniqueposition signal corresponding to the location of a displacement member.As used herein, the term displacement member is used generically torefer to any movable member of the surgical system. In variousinstances, the displacement member may be coupled to any position sensorsuitable for measuring linear displacement. Linear displacement sensorsmay include contact or non-contact displacement sensors. Lineardisplacement sensors may comprise linear variable differentialtransformers (LVDT), differential variable reluctance transducers(DVRT), a slide potentiometer, a magnetic sensing system comprising amovable magnet and a series of linearly arranged Hall Effect sensors, amagnetic sensing system comprising a fixed magnet and a series ofmovable linearly arranged Hall Effect sensors, an optical sensing systemcomprising a movable light source and a series of linearly arrangedphoto diodes or photo detectors, or an optical sensing system comprisinga fixed light source and a series of movable linearly arranged photodiodes or photo detectors, or any combination thereof.

The position sensors 1880, 1890, 6180′, 6280′, 6380′, 7190″, and/or6290′″, for example, may comprise any number of magnetic sensingelements, such as, for example, magnetic sensors classified according towhether they measure the total magnetic field or the vector componentsof the magnetic field. The techniques used to produce both types ofmagnetic sensors encompass many aspects of physics and electronics. Thetechnologies used for magnetic field sensing include search coil,fluxgate, optically pumped, nuclear precession, SQUID, Hall-Effect,anisotropic magnetoresistance, giant magnetoresistance, magnetic tunneljunctions, giant magnetoimpedance, magnetostrictive/piezoelectriccomposites, magnetodiode, magnetotransistor, fiber optic, magnetooptic,and microelectromechanical systems-based magnetic sensors, among others.

In various instances, one or more of the position sensors of thetracking system 1860 comprise a magnetic rotary absolute positioningsystem. Such position sensors may be implemented as an AS5055EQFTsingle-chip magnetic rotary position sensor available from AustriaMicrosystems, AG and can be interfaced with the controller 1840 toprovide an absolute positioning system. In certain instances, a positionsensor comprises a low-voltage and low-power component and includes fourHall-Effect elements in an area of the position sensor that is locatedadjacent a magnet. A high resolution ADC and a smart power managementcontroller are also provided on the chip. A CORDIC processor (forCoordinate Rotation Digital Computer), also known as the digit-by-digitmethod and Volder's algorithm, is provided to implement a simple andefficient algorithm to calculate hyperbolic and trigonometric functionsthat require only addition, subtraction, bitshift, and table lookupoperations. The angle position, alarm bits, and magnetic fieldinformation are transmitted over a standard serial communicationinterface such as an SPI interface to the controller 1840. The positionsensors can provide 12 or 14 bits of resolution, for example. Theposition sensors can be an AS5055 chip provided in a small QFN 16-pin4×4×0.85 mm package, for example.

The tracking system 1860 may comprise and/or be programmed to implementa feedback controller, such as a PID, state feedback, and adaptivecontroller. A power source converts the signal from the feedbackcontroller into a physical input to the system, in this case voltage.Other examples include pulse width modulation (PWM) and/or frequencymodulation (FM) of the voltage, current, and force. Other sensor(s) maybe provided to measure physical parameters of the physical system inaddition to position. In various instances, the other sensor(s) caninclude sensor arrangements such as those described in U.S. Pat. No.9,345,481, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,which is hereby incorporated herein by reference in its entirety; U.S.Patent Application Publication No. 2014/0263552, entitled STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, which is hereby incorporatedherein by reference in its entirety; and U.S. patent application Ser.No. 15/628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTORVELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, which is herebyincorporated herein by reference in its entirety. In a digital signalprocessing system, absolute positioning system is coupled to a digitaldata acquisition system where the output of the absolute positioningsystem will have finite resolution and sampling frequency. The absolutepositioning system may comprise a compare and combine circuit to combinea computed response with a measured response using algorithms such asweighted average and theoretical control loop that drives the computedresponse towards the measured response. The computed response of thephysical system takes into account properties like mass, inertial,viscous friction, inductance resistance, etc., to predict what thestates and outputs of the physical system will be by knowing the input.

The absolute positioning system provides an absolute position of thedisplacement member upon power up of the instrument without retractingor advancing the displacement member to a reset (zero or home) positionas may be required with conventional rotary encoders that merely countthe number of steps forwards or backwards that the motor 1610 has takento infer the position of a device actuator, drive bar, knife, and thelike.

A sensor 1880 comprising a strain gauge or a micro-strain gauge, forexample, is configured to measure one or more parameters of the endeffector, such as, for example, the strain experienced by the jaws 7110and 7120 during a clamping operation. The measured strain is convertedto a digital signal and provided to the processor 1820. In addition toor in lieu of the sensor 1880, a sensor 1890 comprising a load sensor,for example, can measure the closure force applied by the closure drivesystem to the jaws 7110 and 7120. In various instances, a current sensor1870 can be employed to measure the current drawn by the motor 1610. Theforce required to clamp the jaw assembly 7100 can correspond to thecurrent drawn by the motor 1610, for example. The measured force isconverted to a digital signal and provided to the processor 1820. Amagnetic field sensor can be employed to measure the thickness of thecaptured tissue. The measurement of the magnetic field sensor can alsobe converted to a digital signal and provided to the processor 1820.

The measurements of the tissue compression, the tissue thickness, and/orthe force required to close the end effector on the tissue as measuredby the sensors can be used by the controller 1840 to characterize theposition and/or speed of the movable member being tracked. In at leastone instance, a memory 1830 may store a technique, an equation, and/or alook-up table which can be employed by the controller 1840 in theassessment. In various instances, the controller 1840 can provide theuser of the surgical instrument with a choice as to the manner in whichthe surgical instrument should be operated. To this end, the display1440 can display a variety of operating conditions of the instrument andcan include touch screen functionality for data input. Moreover,information displayed on the display 1440 may be overlaid with imagesacquired via the imaging modules of one or more endoscopes and/or one ormore additional surgical instruments used during the surgical procedure.

As discussed above, the drive module 1100 of the handle 1000 and/or theshaft assemblies 2000, 3000, 4000, and/or 5000, for example, attachablethereto comprise control systems. Each of the control systems cancomprise a circuit board having one or more processors and/or memorydevices. Among other things, the control systems are configured to storesensor data, for example. They are also configured to store data whichidentifies the shaft assembly to the handle 1000. Moreover, they arealso configured to store data including whether or not the shaftassembly has been previously used and/or how many times the shaftassembly has been used. This information can be obtained by the handle1000 to assess whether or not the shaft assembly is suitable for useand/or has been used less than a predetermined number of times, forexample.

A drive module 1100′ in accordance with at least one alternativeembodiment is illustrated in FIGS. 51-53. The drive module 1100′ issimilar to the drive module 1100 in many respects, most of which willnot be discussed herein for the sake of brevity. The drive module 1100′comprises an actuator 1420′ configured to control the rotation andarticulation of the end effector 7000. Similar to the actuator 1420,discussed above, the actuator 1420′ is rotatable about a longitudinalaxis LA that extends through a shaft assembly attached to the drivemodule 1100. For instance, the longitudinal axis LA extends through thecenter, or substantially the center, of the elongate shaft 2200 of theshaft assembly 3000 (FIG. 1) when the shaft assembly 3000 is assembledto the drive module 1100′. The longitudinal axis LA also extends throughthe center, or substantially the center, of the end effector 7000 whenthe end effector 7000 is attached to the shaft assembly 3000, forexample.

The actuator 1420′ is rotatable within a channel 1190′ defined in thehousing 1110 in a first direction to rotate the end effector 7000 in thefirst direction and, similarly, in a second, or opposite, direction torotate the end effector 7000 in the second direction. Similar to thedrive module 1100, the drive module 1100′ comprises a sensor system incommunication with the control system 1800 configured to detect therotation of the actuator 1420′ about the longitudinal axis LA. In atleast one instance, the sensor system comprises a first sensor 1422′configured to detect the rotation of the actuator 1420′ about thelongitudinal axis LA in the first direction (FIG. 52A) and a secondsensor 1424′ configured to detect the rotation of the actuator 1420′about the longitudinal axis LA in the second direction (FIG. 52B). Thefirst and second sensors 1422′ and 1424′ comprise Hall Effect sensors,for example, but could comprise any suitable type of sensor. In at leastone such instance, further to the above, the actuator 1420′ comprises acenter magnetic element 1426′ positioned in the top of the actuator1420′ which is detectable by the first and second sensors 1422′ and1424′ to determine the rotation of the actuator 1420′. The centermagnetic element 1426′ can comprise a permanent magnet and/or can becomprised of iron and/or nickel, for example.

Further to the above, the control system 1800 is configured to controlthe motor assembly 1600 and the clutch system 6000 to rotate the endeffector 7000 about the longitudinal axis LA in the first direction whenthe actuator 1420′ is rotated about the longitudinal axis LA in thefirst direction. Similarly, the control system 1800 is configured tocontrol the motor assembly 1600 and the clutch system 6000 to rotate theend effector 7000 about the longitudinal axis LA in the second directionwhen the actuator 1420′ is rotated about the longitudinal axis LA in thesecond direction. By associating the rotation of the end effector 7000about the longitudinal axis LA with the rotation of the actuator 1420′about the longitudinal axis LA, the clinician is provided with a systemthat is very intuitive to use.

As discussed above, the end effector 7000 is configured to rotate abouta longitudinal axis within a socket defined in the distal attachmentportion 2400 of the shaft assembly 2000. Depending on the amount ofrotation desired, the end effector 7000 can be rotated less than 360degrees or more than 360 degrees in either direction. In variousinstances, the end effector 7000 can be rotated through severalrotations in either direction. In alternative embodiments, the rotationof the end effector 7000 about the longitudinal axis can be limited. Inat least one embodiment, the shaft assembly 2000 comprises one or morestops which limit the rotation of the end effector 7000 to less than onerotation. In certain embodiments, the control system 1800 monitors therotation of the drive shaft 1710, such as by an encoder and/or anabsolute positioning sensor system, for example, and limits the rotationof the end effector 7000 by stopping or pausing the motor 1610 when theend effector 7000 has reached the end of its permitted range. In atleast one instance, the control system 1800 can disengage the secondclutch 6210 from the drive shaft 2730 to stop or pause the rotation ofthe end effector 7000 when the end effector 7000 has reached the end ofits permitted range.

Further to the above, the drive module 1100′ and/or a shaft moduleattached to the drive module 1100′ can provide feedback to the clinicianthat the end effector 7000 has reached the end of its rotation. Thedrive module 1100′ and/or the shaft module attached thereto can comprisean indicator light 1427′, such as a red LED, for example, on a firstside of the module housing 1110′ which is illuminated by the controlsystem 1800 when the end effector 7000 has reached the end of itspermitted rotation in the first direction, as illustrated in FIG. 52A.In at least one instance, the drive module 1100′ and/or the shaft moduleattached thereto can comprise an indicator light 1429′, such as a redLED, for example, on a second side of the module housing 1110′ which isilluminated by the control system 1800 when the end effector 7000 hasreached the end of its permitted rotation in the second direction, asillustrated in FIG. 52B. In various instances, further to the above, theillumination of either the first light 1427′ or the second light 1429′can indicate to the clinician that the motor 1610 has been paused andthat the end effector 7000 is no longer rotating. In at least oneinstance, the first light 1427′ and/or the second light 1429′ can blinkwhen the motor 1610 is paused.

In addition to or in lieu of the above, the drive module 1100′ and/orthe shaft assembly attached thereto can comprise an annular series, orarray, of indicator lights 1428′ extending around the perimeter thereofwhich is in communication with the control system 1800 and can indicatethe rotational orientation of the end effector 7000. In at least oneinstance, the control system 1800 is configured to illuminate theparticular indicator light which corresponds, or at least substantiallycorresponds, with the position in which the top of the end effector 7000is oriented. In at least one instance, the center of the first jaw 7110can be deemed the top of the end effector 7000, for example. In suchinstances, the illuminated light indicates the top-dead-center positionof the end effector 7000. In other instances, the control system 1800can illuminate the particular indicator light which corresponds, or atleast substantially corresponds, with the position in which the bottom,or bottom-dead-center, of the end effector 7000 is oriented. In at leastone instance, the center of the second jaw 7210 can be deemed the bottomof the end effector 7000, for example. As a result of the above, theilluminated indicator light can follow the rotation of the end effector7000 around the array of indicator lights 1428′.

Further to the above, the actuator 1420′ is also rotatable, or tiltable,about a transverse axis TA within the housing channel 1190′. The sensorsystem of the drive module 1100′ is further configured to detect therotation of the actuator 1420′ about the transverse axis TA in a firsttilt direction and a second tilt direction. In at least one instance,the sensor system comprises a first tilt sensor 1423′ configured todetect the rotation of the actuator 1420′ about the longitudinal axis TAin the first tilt direction (FIG. 53A) and a second tilt sensor 1425′configured to detect the rotation of the actuator 1420′ in the secondtilt direction (FIG. 53B). The first and second tilt sensors 1423′ and1425′ comprise Hall Effect sensors, for example, but could comprise anysuitable type of sensor. The actuator 1420′ further comprises a firstlateral magnetic element adjacent the first tilt sensor 1423′, themotion of which is detectable by the first tilt sensor 1423′. Theactuator 1420′ also comprises a second lateral magnetic element adjacentthe second tilt sensor 1425′, the motion of which is detectable by thesecond tilt sensor 1425′. The first and second lateral magnetic elementscan comprise a permanent magnet and/or can be comprised of iron and/ornickel, for example. As illustrated in FIGS. 53A and 53B, the lateralsides of the actuator 1420′ are movable proximally and distally aboutthe transverse axis TA and, as a result, the first and second lateralmagnetic elements are also movable proximally and distally relative tothe first and second tilt sensors. The reader should appreciate that,while the first and second lateral magnetic elements actually travelalong arcuate paths about the transverse axis TA, the distances in whichthe first and second lateral magnetic elements move is small and, as aresult, the arcuate motion of the first and second lateral magneticelements approximates translation in the proximal and distal directions.

In various embodiments, further to the above, the entire actuator 1420′comprises a magnetic ring of material which is detectable by the tiltsensors 1423′ and 1425′ of the drive module 1100′. In such embodiments,the rotation of the actuator 1420′ about the longitudinal axis LA wouldnot create a compound motion relative to the tilt sensors when theactuator 1420′ is tilted. The magnetic ring of material can comprise apermanent magnet and/or can be comprised of iron and/or nickel, forexample.

In any event, when the sensor system detects that the actuator 1420′ hasbeen tilted in the first direction, as illustrated in FIG. 53A, thecontrol system 1800 operates the motor assembly 1600 and the clutchsystem 6000 to articulate the end effector 7000 about the articulationjoint 2300 in the first direction. Similarly, the control system 1800operates the motor assembly 1600 and the clutch system 6000 toarticulate the end effector 7000 about the articulation joint 2300 inthe second direction when the sensor system detects that the actuator1420′ has been tilted in the second direction, as illustrated in FIG.53B. By associating the rotation of the end effector 7000 about thearticulation joint 2300 with the rotation of the actuator 1420′ aboutthe transverse axis TA, the clinician is provided with a system that isvery intuitive to use.

Further to the above, the actuator 1420′ comprises a biasing systemconfigured to center the actuator 1420′ in its unrotated and untiltedposition. In various instances, the biasing system comprises first andsecond rotation springs configured to center the actuator 1420′ in itsunrotated position and first and second tilt springs configured tocenter the actuator 1420′ in its untilted position. These springs cancomprise torsion springs and/or linear displacement springs, forexample.

As discussed above, the end effector 7000 rotates relative to the distalattachment portion 2400 of the shaft assembly 3000. Such an arrangementallows the end effector 7000 to be rotated without having to rotate theshaft assembly 3000, although embodiments are possible in which an endeffector and shaft assembly rotate together. That said, by rotating theend effector 7000 relative to the shaft assembly 3000, all of therotation of the surgical system occurs distally relative to thearticulation joint 2300. Such an arrangement prevents a large sweep ofthe end effector 7000 when the end effector 7000 is articulated and thenrotated. Moreover, the articulation joint 2300 does not rotate with theend effector 7000 and, as a result, the articulation axis of thearticulation joint 2300 is unaffected by the rotation of the endeffector 7000. In order to mimic this arrangement, the transverse axisTA does not rotate with the actuator 1420′; rather, the transverse axisTA remains stationary with respect to the drive module 1100′. That said,in alternative embodiments, the transverse axis TA can rotate, or trackthe end effector 7000, when the articulation joint rotates with the endeffector. Such an arrangement can maintain an intuitive relationshipbetween the motion of the actuator 1420′ and the motion of the endeffector 7000.

Further to the above, the transverse axis TA is orthogonal, or at leastsubstantially orthogonal, to the longitudinal axis LA. Similarly, thearticulation axis of the articulation joint 2300 is orthogonal, or atleast substantially orthogonal, to the longitudinal axis LA. As aresult, the transverse axis TA is parallel to, or at least substantiallyparallel to, the articulation axis.

In various alternative embodiments, the tiltable actuator 1420′ is onlyused to control the articulation of the end effector 7000 and is notrotatable about the longitudinal axis LA. Rather, in such embodiments,the actuator 1420′ is only rotatable about the transverse axis TA. In atleast one instance, the housing of the drive module 1100′ comprises twoposts 1421′ (FIG. 51) about which the actuator 1120′ is rotatablymounted which defines the transverse axis TA. The posts 1421′ arealigned along a common axis. The above being said, the posts 1421′, orany suitable structure, can be used in embodiments in which the actuator1420′ is both rotatable and tiltable to control the rotation andarticulation of the end effector 7000. In at least one such instance,the actuator 1420′ comprises an annular groove defined therein in whichthe posts 1421′ are positioned.

In various instances, the drive module 1100 and/or the shaft assemblyattached thereto can comprise a series, or array, of indicator lights1438′ which is in communication with the control system 1800 and canindicate the articulation orientation of the end effector 7000. In atleast one instance, the control system 1800 is configured to illuminatethe particular indicator light which corresponds, or at leastsubstantially corresponds, with the position in which the end effector7000 is articulated. As a result of the above, the illuminated indicatorlight can follow the articulation of the end effector 7000. Such anarray of indicator lights can assist a clinician in straightening theend effector 7000 before attempting to remove the end effector 7000 froma patient through a trocar. In various instances, an unstraightened endeffector may not pass through a trocar and prevent the removable of theend effector from the patient.

A drive module 1100″ in accordance with at least one alternativeembodiment is illustrated in FIGS. 54-57. The drive module 1100″ issimilar to the drive modules 1100 and 1100′ in many respects, most ofwhich will not be discussed herein for the sake of brevity. The drivemodule 1100″ comprises a feedback system configured to inform theclinician using the surgical instrument system that the drive shaftand/or any other rotatable component of the surgical instrument systemis rotating. The feedback system can use visual feedback, audiofeedback, and/or tactile feedback, for example. Referring primarily toFIG. 55, the drive module 1100″ comprises a tactile feedback systemwhich is operably engageable with the drive shaft 1710″ of the drivemodule 1100″. The tactile feedback system comprises a slideable clutch1730″, a rotatable drive ring 1750″, and an eccentric, or offset, mass1770″ mounted to the drive ring 1750″. The clutch 1730″ is slideablebetween an unactuated position (FIG. 56) and an actuated position (FIG.57) along the drive shaft 1710″. The drive shaft 1710″ comprises one ormore slots 1740″ defined therein which are configured to constrain themovement of the slideable clutch 1730″ relative to the drive shaft 1710″such that the clutch 1730″ translates longitudinally relative to thedrive shaft 1710″ but also rotates with the drive shaft 1710″. The frameshaft 1510″ of the handle frame 1500″ comprises an electromagnet 1530″embedded therein which is configured to emit a first electromagneticfield to slide the clutch 1730″ toward its actuated position, asillustrated in FIG. 57, and a second, or opposite, electromagnetic fieldto slide the clutch 1730″ toward its unactuated position, as illustratedin FIG. 56. The clutch 1730″ is comprised of a permanent magnet and/or amagnetic material such as iron and/or nickel, for example. Theelectromagnet 1530″ is controlled by the control system 1800 to apply afirst voltage polarity to a circuit including the electromagnet 1530″ tocreate the first electromagnetic field and a second, or opposite,voltage polarity to the circuit to create the second electromagneticfield.

When the clutch 1730″ is in its unactuated position, as illustrated inFIG. 56, the clutch 1730″ is not operably engaged with the drive ring1750″. In such instances, the clutch 1730″ rotates with the drive shaft1710″, but rotates relative to the drive ring 1750″. Stated another way,the drive ring 1750″ is stationary when the clutch 1730″ is in itsunactuated position. When the clutch 1730″ is in its actuated position,as illustrated in FIG. 57, the clutch 1730″ is operably engaged with anangled face 1760″ of the drive ring 1750″ such that the rotation of thedrive shaft 1710″ is transmitted to the drive ring 1750″ via the clutch1730″ when the drive shaft 1710″ is rotated. The eccentric, or offset,mass 1770″ is mounted to the drive ring 1750″ such that the eccentricmass 1770″ rotates with the drive ring 1750″. In at least one instance,the eccentric mass 1770″ is integrally-formed with the drive ring 1750″.When the drive ring 1750″ and eccentric mass 1770″ rotate with the driveshaft 1710″, the eccentric mass 1770″ creates a vibration that can befelt by the clinician through the drive module 1100″ and/or the powermodules assembled thereto. This vibration confirms to the clinician thatthe drive shaft 1710″ is rotating. In at least one instance, the controlsystem 1800 energizes the electromagnet 1530″ when one of the clutchesof the clutch system 6000 is energized. In such instances, the vibrationcan confirm to the clinician that the drive shaft 1710″ is rotating andthat one of the clutches in the clutch system 6000 is engaged with thedrive shaft 1710″. In at least one instance, the clutch 1730″ can beactuated when the jaw assembly 7100, for example, has reached or isreaching its closed position such that the clinician knows that thetissue has been clamped within the jaw assembly 7100 and that thesurgical instrument can be used to manipulate the tissue. The abovebeing said, the tactile feedback system, and/or any other feedbacksystem, of the drive module 1100″ can be used to provide tactilefeedback when appropriate.

As surgical techniques continue to advance and develop, there is a needfor specialized surgical instruments. With the advent of 3-D printingand additive manufacturing, new methods and techniques have beendeveloped to produce specialized surgical instruments. Customizedsurgical instruments can allow a technician or surgeon to produce anduse surgical instruments that are customized to a patient'sphysiological conditions or for a specific surgical procedure.

Out of an abundance of caution, many surgical instruments have becomeone-use devices to prevent the spread of contamination or diseasesbetween patients. As surgical devices are becoming single patient andsingle-use devices, customizing the devices for the specific patient canallow for better results and faster recovery time for patients. Asrecovery time for patients is a substantial cost to the healthcaresystem, having customized surgical devices that allow surgeons tospecifically target and resolve a patient's ailment can greatly reducethe overall healthcare spend.

Surgical instruments, such as surgical dissectors have been inwidespread use in various surgical procedures. These instruments allow asurgeon to manipulate, separate, and remove specific areas of tissue ofa patient. Having the ability to develop custom dissectors for specificsurgical procedures and for a patient's physiological conditions can beof great value.

As different surgical procedures and patient conditions requiredifferent surgical instruments, the present disclosure relates tocustomized surgical devices, methods of producing customized devices,and means for producing customized surgical devices using varioustechniques, such as additive manufacturing and/or 3-D printing, forexample.

In developing customized surgical devices, a surgeon can determine thespecifics of the required device based upon the specific procedure, thegeneral size of the patient, i.e., a child vs. an adult, or throughscans and/or x-rays of the patient to determine the specific profilerequired for the surgical instrument.

When a surgeon is customizing a surgical instrument for a specificprocedure, they may consult a directory of predefined surgicalinstrument shapes and configurations to determine which device may bestsuit the procedure at hand. Such procedures for the production ofultrasonic blades are discussed in U.S. Patent Application PublicationNo. 2018/0014844 A1 to Conlon, titled ULTRASONIC SURGICAL INSTRUMENTWITH AS HOC FORMED BLADE, the disclosure of which is incorporated byreference in its entirety.

Once the surgeon determines the desired device characteristics, thesurgeon may take a base device, such as a end effector connector havinga core or stub and use an additive manufacturing process to produce theselected end effector configuration. In addition, or in the alternative,a surgeon may use the size of a patient to determine the required sizeof the surgical instrument. The surgeon may use various physiologicalstandards, such as the size of the patients hand, tibia, abdomen, orother physiological marker that can provide an adequate representationof the desired size of the surgical instrument. In addition, or in thealternative, the surgeon may conduct scans or x-rays of the patient todetermine the specific size, shape, and characteristic of the surgicaldevice needed to perform a desired procedure.

FIG. 58 illustrates a surgical end effector 100000 having a standardconnection portion 100050 and a customizable end effector portion100060. The standard connection portion 100050 includes a first jawportion 100006 and a second jaw portion 100008. The first jaw portion100006 and the second jaw portion 100008 are rotatable about a joint100004. The standard connection portion 100050 of the surgical endeffector 100000 can be connected to a shaft of a surgical instrument.The shaft of the surgical instrument can have a diameter D. Thecustomizable end effector portion 100060 can be customized within thecustomization region 100002, such that the diameter of the customizationregion 100002 is equal to or less than the diameter D of the shaft ofthe surgical instrument. With the customizable end effector portion100060 being confined to the bounds of the customization region 100002,the surgical end effector 100000 can be inserted through a trocar into apatient's body cavity through minimally invasive surgical procedures.

The first jaw portion 100006 of the end effector portion 100060 includesa core/stub portion 100010 that is adaptable through additivemanufacturing techniques. The core/stub portion 100010 provides a basefor building and customizing the geometry and characteristics of acustomizable jaw 100012. Depending on various needs for the surgicalprocedure, the customizable jaw 100012 can be modified and adapted tomeet the needs of the surgeon.

In certain embodiments, the surgical end effector 100000 can comprise asolid customizable region 100002. The solid customizable region 100002can be made of various materials such as various metals and/or plastics,for example. When the surgeon determines the configuration required forthe surgical procedure, the surgeon can use a manufacturing technique toremove the excess material to leave the desired shape of thecustomizable jaw 100012. In the alternative, the surgeon may start witha surgical end effector 100000 that does not have a core/stub portion100100 and, instead, only has a standard connector portion 100050. Withjust the standard connector portion 100050, the surgeon can use amanufacturing process to create the desired shape and features of thecustomized jaw 100012 within the bounds of the customization region100002.

In another embodiment, a surgical instrument may have a surgical endeffector 100100, as illustrated in FIG. 59. The surgical end effector100100 has a standard connection portion 100150 and a customizable endeffector portion 100160. The standard connection portion 100150 includesa first jaw portion 100106 and a second jaw portion 100108. The firstjaw portion 100106 and the second jaw portion 100108 are rotatable abouta joint 100104. The standard connection portion 100150 of the surgicalend effector 100100 can be connected to a shaft of a surgicalinstrument. The shaft of the surgical instrument can have a diameter D.The customizable end effector portion 100160 can be customized withinthe customization region 100102 such that the diameter of thecustomization region 100102 is equal to or less than the diameter D ofthe shaft of the surgical instrument. With the customizable end effectorportion 100160 being confined to the bounds of the customization region100102, the surgical end effector 100100 can be inserted through atrocar into a patient's body cavity through minimally invasive surgicalprocedures.

The first jaw portion 100106 of the end effector portion 100160 includesa core/stub portion 100110 that is adaptable through additivemanufacturing techniques. The core/stub portion 100110 provides a basefor building and customizing the geometry and characteristics of a firstcustomizable jaw 100112 and a second customizable jaw 100114. Dependingon various needs for the surgical procedure, the first customizable jaw100112 and the second customizable jaw 100114 can be modified andadapted to meet the needs of the surgeon. The first customizable jaw100112 and the second customizable jaw 100114 have a plurality ofproximal features 100118 and a plurality of distal features 100116. Asillustrated in FIG. 59, the plurality of proximal features 100118comprises a plurality of proximal teeth. The plurality of distalfeatures 100116 comprises a plurality of distal teeth. The proximalteeth are smaller and have a smaller height than the distal teeth. Theprogression of larger distal teeth to smaller proximal teeth can allowfor a more aggressive hold and manipulation of tissue when using thedistal portion of the first and second customizable jaws 100112, 100114.In various embodiments, however, the plurality of proximal and distalteeth may take various configurations based upon the needs of thesurgical procedure, such as for example, a plurality of symmetricalteeth, a plurality of asymmetrical teeth, and/or a progression fromlarge to small or small to large teeth.

In certain embodiments, the surgical end effector 100100 comprises asolid customized region 100102. The solid customizable region 100002 canbe made of various materials such as various metals and/or plastics, forexample. When the surgeon determines the configuration of the endeffector 100100 required for the surgical procedure, the surgeon can usea manufacturing technique, such as grinding, wire EDMing, and/orpolishing, for example, to remove the excess material to leave thedesired shape of the customizable jaw 101012. In the alternative, thesurgeon may start with a surgical end effector 100100 that only has astandard connector portion 100150. With just the standard connectorportion 100150, the surgeon can use a manufacturing process to createthe desired shape and features of the customized jaw 100112 within thebounds of the customization region 100102.

FIG. 60 illustrates a surgical end effector 100200 that is configured tobe modified and adjusted using various manufacturing techniques at thediscretion of a surgeon. The surgical end effector 100200 includes astandard connection portion 100250 and a customizable end effectorportion 100260. The standard connection portion 100250 includes a firstjaw portion 100206 and a second jaw portion 100208.

The customizable end effector portion 100260 can be customized withinthe customization region 100202, such that the diameter of thecustomization region 100202 is equal to or less than the diameter D ofthe shaft of the surgical instrument. With the customizable end effectorportion 100260 being confined to the bounds of the customization region100202, the surgical end effector 100200 can be inserted through atrocar into a patient's body cavity during minimally invasive surgicalprocedures.

The surgical end effector 100200 is illustrated as having variousdifferent customized jaw configurations 100212 a-e. The variouscustomized jaw configurations 100212 a-e can be selected by a surgeon orclinician depending upon the type of procedure and a patient'sphysiological condition. The various customized jaw configurations100212 a-e can include different shape profiles, different diameters,different geometries, and can be comprised of various materials. In oneembodiment, the various customized jaw configurations 100212 a-e can becomprised of various plastics having different durometers anddeformation characteristics. In another embodiment, the variouscustomized jaw configurations 100212 a-e can comprise metallic materialsand materials having a greater rigidity. In addition, or in thealternative, the various customized jaw configurations 100212 a-e canalso comprise a combination of metallic and plastic materials to providea desired characteristic to the surgical end effector 100200.

In certain embodiments, the various customized jaw configurations 100212a-e can have a metallic core with plastic and/or metal overlaid upon thecore. The various materials used in the various customized jawconfigurations 100212 a-e can create end effectors meeting the needs ofthe surgeon, procedure, and/or patient.

FIG. 61 illustrates a surgical end effector 100300 that is configured tobe modified and adjusted using various manufacturing techniques at thediscretion of a surgeon. The surgical end effector 100300 includes astandard connection portion 100350 and a customizable end effectorportion 100360. The standard connection portion 100350 includes a firstjaw portion 100306 and a second jaw portion 100308. The first jawportion 100306 and the second jaw portion 100308 are rotatable about ajoint 100304.

The customizable end effector portion 100360 can be customized withinthe customization region 100302, such that, the diameter of thecustomization region 100302 is equal to or less than the diameter D ofthe shaft of the surgical instrument. With the customizable end effectorportion 100360 being confined to the bounds of the customization region100302, the surgical end effector 100300 can be inserted through atrocar into a patient's body cavity through minimally invasive surgicalprocedures.

The first jaw portion 100306 of the end effector portion 100360 includesa core/stub portion 100310 that is adaptable through additivemanufacturing techniques. The core/stub portion 100310 provides a basefor building and customizing the geometry and characteristics of a firstcustomizable jaw 100312 and a second customizable jaw 100314. Dependingon various needs for the surgical procedure, the first customizable jaw100312 and the second customizable jaw 100314 can be modified andadapted to meet the needs of the surgeon. The first customizable jaw100312 and the second customizable jaw 100314 have a plurality ofproximal features 100318 and a plurality of distal features 100316. Asillustrated in FIG. 61, the plurality of proximal features 100318comprises a plurality of proximal teeth. The plurality of distalfeatures 100316 comprises a plurality of distal teeth. The plurality ofproximal teeth is approximately the same height as the plurality ofdistal teeth. However, in various embodiments the plurality of proximaland distal teeth may take various configurations based upon the needs ofthe surgical procedure, for example a plurality of symmetrical teeth, aplurality of asymmetrical teeth, and/or a progression from large tosmall or small to large teeth. In the alternative, the surgical endeffector 100300 can include a plurality of miniature, or fine, teeth100320. The various features 100316, 100318 and miniature teeth 100320can extend along the first customizable jaw 100312 and the secondcustomizable jaw 100314 in various lengths, can have smooth profiles,and/or can have sharper profiles depending on the desired configurationof the surgical end effector 100300.

FIG. 61 illustrates various different customized jaw configurations100322 a-c. In a first embodiment, the customized jaw configuration100322 a can comprise a curved end effector region. In a secondalternative embodiment, the customized jaw configuration 100322 b cancomprise a protruding outer profile that can allow the surgical endeffector 100300 to function as a dissector and divide tissue when thefirst jaw portion 100306 and the second jaw portion 100308 are rotatedabout a joint 100304 between an open configuration and a closedconfiguration. In a third alternative embodiment, the customized jawconfiguration 100322 c can comprise a longitudinal linear body. Otherembodiments and configurations of the surgical end effector 100300 arealso possible. One constraint on the configuration of the customizableend effector portion 100360 is that it should be confined to the boundsof the customization region 100302 so that the surgical end effector100300 can be inserted through a trocar into a patient's body cavitythrough minimally invasive surgical procedures. In embodiments where thesurgical end effector 100300 is being used in open surgical procedures,the customizable end effector portion 100360 can exceed the bounds ofthe customization region 100302. Also, embodiments are envisioned wherea portion of the end effector is collapsible to permit laparoscopic endeffectors to fit through a trocar. In such embodiments, the bounds ofthe customizable region can be larger than the diameter D of the shaft.

FIGS. 62 and 63 illustrate a surgical end effector 100400. The surgicalend effector 100400 is configured to be modified and adjusted usingvarious manufacturing techniques at the discretion of a surgeon. Thesurgical end effector 100400 includes a standard connection portion100450 and a customizable end effector portion 100460. The standardconnection portion 100450 includes a first jaw portion 100406 and asecond jaw portion 100408. The first jaw portion 100406 and the secondjaw portion 100408 are rotatable about a joint 100404.

The customizable end effector portion 100460 can be customized withinthe customization region 100402, such that the diameter of thecustomization region 100402 is equal to or less than the diameter D ofthe shaft of the surgical instrument. With the customizable end effectorportion 100460 being confined to the bounds of the customization region100402, the surgical end effector 100400 can be inserted through atrocar into a patient's body cavity through minimally invasive surgicalprocedures.

The first jaw portion 100406 of the end effector portion 100460 includesa core/stub portion 100410 that is adaptable through additivemanufacturing techniques. The core/stub portion 100410 provides a basefor building and customizing the geometry and characteristics of a firstcustomizable jaw 100412 and a second customizable jaw 100414. Dependingon various needs for the surgical procedure, the first customizable jaw100412 and the second customizable jaw 100414 can be modified andadapted to meet the needs of the surgeon. The first customizable jaw100412 and the second customizable jaw 100414 have a plurality ofproximal features 100418 and a plurality of distal features 100416. Asillustrated in FIG. 63, the plurality of proximal features 100418comprises a plurality of proximal teeth. The plurality of distalfeatures 100416 comprises a plurality of distal teeth. The plurality ofproximal teeth is approximately the same height as the plurality ofdistal teeth. However, in various embodiments, the plurality of proximaland distal teeth may take various configurations based upon the needs ofthe surgical procedure such as, for example, a plurality of symmetricalteeth, a plurality of asymmetrical teeth, and/or a progression fromlarge to small or small to large teeth.

In addition, the first customizable jaw 100412 and the secondcustomizable jaw 100414 have a plurality of features 100430 and 100432,respectively, that are positioned on the outer portion of the first andsecond customizable jaws 100412, 100414. As illustrated in FIG. 63, thefeatures 100430, 100432 can include ridges, or teeth, that allow thesurgical end effector 100400 to engage, grasp, and/or manipulate tissue.

When selecting the configuration and various features for the surgicalend effector 100400, the external features 100430, 100432, the proximalfeatures 100418, the distal features 100416, the overall geometric shapeof the first and second customizable jaws 100412, 100414, and thematerials used in producing the customizable end effector portion 100460are independent variables that are considered during the customizationprocess. For example, when the surgical end effector 100400 is beingcustomized for a minimally invasive surgical procedure, the variousindependent variables must result in an overall profile that fallswithin the customization region 100402 so that the surgical end effector100400 can be inserted through a trocar and into a patient's bodycavity.

FIGS. 64-67 illustrate surgical end effectors having various featuresand profiles. FIG. 64 illustrates a surgical end effector 100500 that isconfigured to be modified and adjusted using various manufacturingtechniques at the discretion of a surgeon. The surgical end effector100500 includes a standard connection portion 100550 and a customizableend effector portion 100560. The standard connection portion 100550 caninclude a first jaw portion 100506 and a second jaw portion 100508. Thefirst jaw portion 100506 and the second jaw portion 100508 are rotatableabout a joint 100504.

The customizable end effector portion 100560 can be customized within acustomization region 100502, such that the diameter of the customizationregion 100502 is equal to or less than the diameter D of the shaft ofthe surgical instrument. With the customizable end effector portion100560 being confined to the bounds of the customization region 100502,the surgical end effector 100500 can be inserted through a trocar into apatient's body cavity through minimally invasive surgical procedures.

The customizable end effector portion 100560 can be produced throughvarious additive manufacturing techniques to produce custom geometry andcharacteristics of a first customizable jaw 100512 and a secondcustomizable jaw 100514. Depending on various needs for the surgicalprocedure, the first customizable jaw 100512 and the second customizablejaw 100514 can be modified and adapted to meet the needs of the surgeon.The first customizable jaw 100512 and the second customizable jaw 100514have a plurality of proximal features 100518 and a plurality of distalfeatures 100516. As illustrated in FIG. 64, the plurality of proximalfeatures 100518 comprises a plurality of small symmetrical proximalteeth. The plurality of distal features 100516 comprises a plurality ofsmall symmetrical distal teeth. The plurality of proximal teeth isapproximately the same height as the plurality of distal teeth and arecontinuous along the inner surfaces of the first customizable jaw 100512and the second customizable jaw 100514. In addition, the firstcustomizable jaw 100512 and the second customizable jaw 100514 compriseexternal surface features 100530, 100532, respectively. As illustratedin FIG. 64, the external surface features 100530, 100532 comprisesubstantially smooth surfaces. However, in alternative embodiments, theexternal surface features 100530, 100532 may comprise teeth, nubs and/orother protrusions to assist with the tissue interaction of the surgicalend effector 100500.

FIG. 65 illustrates surgical end effector 100600 that is configured tobe modified and adjusted using various manufacturing techniques at thediscretion of a surgeon. The surgical end effector 100600 includes astandard connection portion 100650 and a customizable end effectorportion 100660. The standard connection portion 100650 can include afirst jaw portion 100606 and a second jaw portion 100608. The first jawportion 100606 and the second jaw portion 100608 are rotatable about ajoint 100604.

The customizable end effector portion 100660 can be customized within acustomization region 100602, such that the diameter of the customizationregion 100602 is equal to or less than the diameter D of the shaft ofthe surgical instrument. With the customizable end effector portion100660 being confined to the bounds of the customization region 100602,the surgical end effector 100600 can be inserted through a trocar into apatient's body cavity through minimally invasive surgical procedures.

The customizable end effector portion 100660 can be produced throughvarious additive manufacturing techniques to produce custom geometry andcharacteristics of a first customizable jaw 100612 and a secondcustomizable jaw 100614. Depending on various needs for the surgicalprocedure, the first customizable jaw 100612 and the second customizablejaw 100614 can be modified and adapted to meet the needs of the surgeon.The first customizable jaw 100612 and the second customizable jaw 100614have a plurality of proximal features 100618 and a plurality of distalfeatures 100616. As illustrated in FIG. 65, the plurality of proximalfeatures 100618 comprises a substantially smooth surface. The pluralityof distal features 100616 comprises a plurality of large distal teeth.The plurality of large distal teeth is only formed on a portion of theinner surfaces of the first customizable jaw 100612 and the secondcustomizable jaw 100614. In addition, the first customizable jaw 100612and the second customizable jaw 100614 comprise external surfacefeatures 100630, 100632, respectively. As illustrated in FIG. 65, theexternal surface features 100630, 100632 comprise substantially smoothsurfaces. However, in alternative embodiments, the external surfacefeatures 100630, 100632 may comprise teeth, nubs, and/or otherprotrusions to assist with the tissue interaction of the surgical endeffector 100600.

FIG. 66 illustrates a surgical end effector 100700 that is configured tobe modified and adjusted using various manufacturing techniques at thediscretion of a surgeon. The surgical end effector 100700 includes astandard connection portion 100750 and a customizable end effectorportion 100760. The standard connection portion 100750 includes a firstjaw portion 100706 and a second jaw portion 100708. The first jawportion 100706 and the second jaw portion 100708 are rotatable about ajoint 100704.

The customizable end effector portion 100760 can be customized within acustomization region 100702. The diameter of the customization region100702 is equal to or less than the diameter D of the shaft of thesurgical instrument. With the customizable end effector portion 100760being confined to the bounds of the customization region 100702, thesurgical end effector 100700 can be inserted through a trocar into apatient's body cavity through minimally invasive surgical procedures.

The customizable end effector portion 100760 can be produced throughvarious additive manufacturing techniques to produce custom geometry andcharacteristics of a first customizable jaw 100712 and a secondcustomizable jaw 100714. Depending on various requirements for thesurgical procedure, the first customizable jaw 100712 and the secondcustomizable jaw 100714 can be modified and adapted to meet the needs ofthe surgeon. The first customizable jaw 100712 and the secondcustomizable jaw 100714 have a plurality of proximal features 100718 anda plurality of distal features 100716. As illustrated in FIG. 66, theplurality of proximal features 100718 comprises a substantially smoothsurface. The plurality of distal features 100716 comprises a pluralityof smooth distal teeth. The plurality of smooth distal teeth is onlyformed on a portion of the inner surfaces of the first customizable jaw100712 and the second customizable jaw 100714. In addition, the firstcustomizable jaw 100712 and the second customizable jaw 100714 compriseexternal surface features 100730, 100732, respectively. As illustratedin FIG. 66, the external surface features 100730, 100732 comprisesubstantially smooth surfaces. However, in alternative embodiments, theexternal surface features 100730, 100732 may comprise teeth, nubs,and/or other protrusions to assist with the tissue interaction of thesurgical end effector 100700.

FIG. 67 illustrates a surgical end effector 100800 that is configured tobe modified and adjusted using various manufacturing techniques at thediscretion of a surgeon. The surgical end effector 100800 includes astandard connection portion 100850 and a customizable end effectorportion 100860. The standard connection portion 100850 can include afirst jaw portion 100806 and a second jaw portion 100808. The first jawportion 100806 and the second jaw portion 100808 are rotatable about ajoint 100804.

The customizable end effector portion 100860 can be customized within acustomization region 100802, such that the diameter of the customizationregion 100802 is equal to or less than the diameter D of the shaft ofthe surgical instrument. With the customizable end effector portion100860 being confined to the bounds of the customization region 100802,the surgical end effector 100800 can be inserted through a trocar into apatient's body cavity through minimally invasive surgical procedures.

The customizable end effector portion 100860 can be produced throughvarious additive manufacturing techniques to produce custom geometry andcharacteristics of a first customizable jaw 100812 and a secondcustomizable jaw 100814. Depending on various requirements for thesurgical procedure, the first customizable jaw 100812 and the secondcustomizable jaw 100814 can be modified and adapted to meet the needs ofthe surgeon. The first customizable jaw 100812 and the secondcustomizable jaw 100814 have a plurality of proximal features 100818 anda plurality of distal features 100816. As illustrated in FIG. 67, theplurality of proximal features 100818 comprises a substantially smoothsurface. The plurality of distal features 100816 comprises asubstantially smooth surface of low durometer material. The lowdurometer material allows the inner surfaces of the first customizablejaw 100812 and the second customizable jaw 100814 to grasp andmanipulate an object, such as a patient's tissue.

The substantially smooth surface of low durometer material is onlyformed on a portion of the inner surfaces of the first customizable jaw100812 and the second customizable jaw 100814. The substantially smoothsurface can refer to a surface, for example, that is substantially freefrom projections or unevenness, generally flat or unruffled, and/orsubstantially of uniform consistency. In addition, the firstcustomizable jaw 100812 and the second customizable jaw 100814 compriseexternal surface features 100830, 100832, respectively. As illustratedin FIG. 67, the external surface features 100830, 100832 comprisesubstantially smooth surfaces. However, in alternative embodiments, theexternal surface features 100830, 100832 may comprise teeth, nubs,and/or other protrusions to assist with the tissue interaction of thesurgical end effector 100800.

FIGS. 68 and 69 illustrate another embodiment of a surgical end effector100900. The surgical end effector 100900 is configured to be modifiedand adjusted using various manufacturing techniques at the discretion ofa surgeon. The surgical end effector 100900 includes a standardconnection portion 100950 and a customizable end effector portion100960. The standard connection portion 100950 can include a first jawportion 100906 and a second jaw portion 100908. The first jaw portion100906 and the second jaw portion 100908 are rotatable about a joint100904.

The customizable end effector portion 100960 can be customized withinthe customization region 100902. The diameter of the customizationregion 100902 is equal to or less than the diameter D of the shaft ofthe surgical instrument. With the customizable end effector portion100960 being confined to the bounds of the customization region 100902,the surgical end effector 100900 can be inserted through a trocar into apatient's body cavity through minimally invasive surgical procedures.

The surgical end effector 100900 includes a core/stub portion 100910that is adaptable through additive manufacturing techniques. Thecore/stub portion 100910 provides a base for building and customizingthe geometry and characteristics of a first customizable jaw 100912 anda second customizable jaw 100914. Depending on various needs for thesurgical procedure, the first customizable jaw 100912 and the secondcustomizable jaw 100914 can be modified and adapted to meet the needs ofthe surgeon. The first customizable jaw 100912 and the secondcustomizable jaw 100914 have a plurality of proximal features 100918 anda plurality of distal features 100916. As illustrated in FIG. 69, theplurality of proximal features 100918 comprises a plurality of proximalteeth. The plurality of distal features 100916 comprises a plurality ofdistal teeth. The plurality of proximal teeth is approximately the sameheight as the plurality of distal teeth. However, in various embodimentsthe plurality of proximal and distal teeth may take variousconfigurations based upon the needs of the surgical procedure, forexample a plurality of symmetrical teeth, a plurality of asymmetricalteeth, and/or a progression from large to small or small to large teeth.

In addition, the first customizable jaw 100912 and the secondcustomizable jaw 100914 have a plurality of features 100930 and 100932,respectively that are positioned on the outer portion of the first andsecond customizable jaws 100912, 100914. As illustrated in FIG. 69, thefeatures 100930, 100932 can include ridges, and/or substantially smoothsurfaces that allow the surgical end effector 100900 to engage, grasp,and/or manipulate an object, for example a patient's tissue.

FIG. 68 depicts a top plan view of the surgical end effector 100900.FIG. 69 depicts a side elevation view of the surgical end effector100900. The overall geometric shape of the surgical end effector 100900is a curved configuration. From the depictions of the surgical endeffector 100900 in FIGS. 68 and 69, it will be apparent to a person ofordinary skill in the art that the overall profile of the surgical endeffector 100900 has a three dimensional curved geometry.

When selecting the configuration and various features for the surgicalend effector 100900, the external features 100930, 100932, the proximalfeatures 100918, the distal features 100916, the overall geometric shapeof the first and second customizable jaws 100912, 100914, and thematerials used in producing the customizable end effector portion 100960are independent variables that are considered during the customizationprocess. For example, when the surgical end effector 100900 is beingcustomized for a minimally invasive surgical procedure, the variousindependent variables must produce an overall profile of the surgicalinstrument that falls within the customization region 100902 so that thesurgical end effector 100900 can be inserted through a trocar and into apatient's body cavity.

FIGS. 70 and 71 illustrate another embodiment of a surgical end effector101000. The surgical end effector 101000 is configured to be modifiedand adjusted using various manufacturing techniques at the discretion ofa surgeon. The surgical end effector 101000 includes a standardconnection portion 101050 and a customizable end effector portion101060. The standard connection portion 101050 can include a first jawportion 101006 and a second jaw portion 101008. The first jaw portion101006 and the second jaw portion 101008 are rotatable about a joint101004.

The customizable end effector portion 101060 can be customized withinthe customization region 101002. The diameter of the customizationregion 101002 is equal to or less than the diameter D of the shaft ofthe surgical instrument. With the customizable end effector portion101060 being confined to the bounds of the customization region 101002,the surgical end effector 101000 can be inserted through a trocar into apatient's body cavity through minimally invasive surgical procedures.

The surgical end effector 101000 includes a core/stub portion 101010that is adaptable through additive manufacturing techniques. Thecore/stub portion 101010 provides a base for building and customizingthe geometry and characteristics of a first customizable jaw 101012 anda second customizable jaw 101014. Depending on various needs for thesurgical procedure, the first customizable jaw 101012 and the secondcustomizable jaw 101014 can be modified and adapted to meet the needs ofthe surgeon. The first customizable jaw 101012 and the secondcustomizable jaw 101014 have a plurality of proximal features 101018 anda plurality of distal features 101016. As illustrated in FIG. 71, theplurality of proximal features 101018 comprises a plurality of proximalteeth. The plurality of distal features 101016 comprises a plurality ofdistal teeth. The plurality of proximal teeth is approximately the sameheight as the plurality of distal teeth. However, in various embodimentsthe plurality of proximal and distal teeth may take variousconfigurations based upon the needs of the surgical procedure such as,for example, a plurality of symmetrical teeth, a plurality ofasymmetrical teeth, and/or a progression from large to small or small tolarge teeth.

In addition, the first customizable jaw 101012 and the secondcustomizable jaw 101014 have a plurality of features 101030 a-d and101032 a-d, respectively that are positioned on the outer portion of thefirst and second customizable jaws 101012, 101014. As illustrated inFIG. 71, the features 101030 a and 101032 a comprise distal concavefeatures. The features 101030 a and 101032 a can have a low durometersurface that is sticky to the touch and can be used to manipulate anobject, such as tissue. In at least one instance, the low-durometerfeatures 101030 a and 101032 a have a durometer between about 15 andabout 70 Shore OO, for example. In certain instances, the low-durometerfeatures 101030 a and 101032 a have a durometer between about 15 andabout 70 Shore A, for example. The features 101030 b and 101032 bcomprise convex protruding features. The features 101030 b and 101032 bcan have a low durometer surface that is sticky to the touch and can beused to manipulate an object, such as tissue. In at least one instance,the low-durometer features 101030 b and 101032 b have a durometerbetween about 15 and about 70 Shore OO, for example. In certaininstances, the low-durometer features 101030 b and 101032 b have adurometer between about 15 and about 70 Shore A, for example. Thefeatures 101030 c and 101032 c comprise concave features. The features101030 c and 101032 c can have a low durometer surface that is sticky tothe touch and can be used to manipulate an object, such as tissue. Thefeatures 101030 d and 101032 d comprise a substantially smooth surface.The features 101030 d and 101032 d can have a low durometer surface thatis sticky to the touch and can be used to manipulate an object, such astissue.

In addition, or in the alternative, various additional configurationsfor the features 101030 a-d and 101032 a-d are possible. The feature101030 a-d and 101032 a-d can include ridges, and/or substantiallysmooth surfaces that allow the surgical end effector 101000 to engage,grasp, and/or manipulate an object, for example a patient's tissue.

FIG. 70 depicts a top plan view of the surgical end effector 101000.FIG. 71 depicts a side elevation view of the surgical end effector101000. The overall geometric shape of the surgical end effector 101000is a substantially linear configuration.

When selecting the configuration and various features for the surgicalend effector 101000, the external features 101030 a-d, 101032 a-d, theproximal features 101018, the distal features 101016, the overallgeometric shape of the first and second customizable jaws 101012,101014, and the materials used in producing the customizable endeffector portion 101060 are independent variables that are consideredduring the customization process. For example, when the surgical endeffector 101000 is being customized for a minimally invasive surgicalprocedure, the various independent variables must produce an overallprofile that falls within the customization region 101002 so that thesurgical end effector 101000 can be inserted through a trocar and into apatient's body cavity.

The various end effectors described above with respect to FIGS. 58-71can be produced through a multi-step process where a first portion ofthe end effector, such as, a standard connection portion, for example,is produced in a manufacturing facility and shipped to hospitals ordistributed to manufacturing hubs. Once the standard connection portionis at its end location, such as a hospital, or at a manufacturingfacility, the standard connection portion can be customized to producean end effector meeting the needs of the user. Such customization canallow surgical end effectors to be produced for specific proceduresand/or specific patients.

The customized end effectors described above with respect to FIGS. 58-71can be produced through various techniques. A clinician can access, forexample, a dedicated human-machine interface to select and design thedesired attributes of an end effector. The human-machine interface cancomprise, for example, a graphical user interface of a computer. Thecomputer can be connected to a manufacturing device. Thecomputer-manufacturing device interface can be wired, wireless, and/orremote, for example, via the internet. When the clinician accesses thehuman-machine interface, they can select the various attributes desiredof the end effector.

When selecting the various attributes of the end effector, the cliniciancan use information gained from the patient or information about theparticular procedure to guide their design of the end effector. When theclinician is using information regarding a particular patient, forexample, the patient's information can come from various patient tests,such as MRIs, X-rays, CT Scans, and/or other medical tests. Thesetesting results can be entered into the computer and used to control thedesign parameters of the end effector. When the clinician uses theresults of an MRI, for example, to detect a patient's tumor, the sizeand shape of the patient's tumor can be used as design parameters whenproducing the customized end effector.

In addition, or in the alternative, the clinician can use parametersfrom the particular surgical procedure to design the customized endeffector. When the end effector is being designed for various bariatricprocedures, for example, the requirements of the specific procedure,such as the size of a gastric bypass reduction, can be used as thedesign parameters when producing the customized end effector.

In selecting the various features for the end effector, the cliniciancan use various software programs to design the desired features of theend effector. The clinician, for example, can input the patient's scansand/or medical test information into the computer and a software programcan determine the design features of the end effector to match thepatient's condition. Once the software program approximates thenecessary features of the end effector, the clinician can review and/ormodify the parameters of the end effector using the human-machineinterface.

In addition, or in the alternative, the clinician can access a softwareprogram using the human-machine interface to design the features of theend effector. The clinician, for example, can access the softwareprogram and select various predetermined shapes, features, and/ordesigns to combine to produce an end effector having the desiredfeatures. The clinician may also use a free-form command in the softwareto freely design the desired features of the end effector.

Once the features of the customized end effector are determined, theclinician and/or manufacturing staff can insert a core/stub portion intoa manufacturing device. The manufacturing device is in communicationwith the human-machine interface of the computer via a wired, wireless,and/or remote internet connection. The clinician, using the softwareprogram, can send the design parameters to the manufacturing device toproduce the end effector.

The manufacturing device can be designed to use various manufacturingprocesses or techniques. The manufacturing device, for example, can be ametal injection molding device, a plastic injection molding device, aCNC machine, an EDM device, a 3-D printing device, and/or various othermanufacturing devices, such as additive manufacturing devices.

After the design parameters are transferred from the computer to themanufacturing device, the software controlling the manufacturing devicecauses the manufacturing device to perform a manufacturing procedure toproduce the customized end effector. The manufacture procedure can addmaterial to the core/stub portion of the end effector. In thealternative, the manufacturing procedure can remove material from thecore/stub portion of the end effector. The manufacturing device can useone or more of the techniques described above in the production of thecustomized end effector. Once the manufacturing device has completed theoverall design and structure of the customized end effector, thecustomized end effector can be finished or polished using a finishingmachine and/or process. The finishing machine may be part of themanufacturing device, or it can be a separate machine/device.

Once the structure of the customized end effector is completed, thecustomized end effector can be tested, cleaned, and/or sterilized. Thetesting process can ensure that the customized end effector is designedto the necessary standards for the particular medical device. Thecleaning process can remove any excess residual material leftover fromthe manufacturing process. The sterilization process can sterilize theend effector so that it can be used in a surgical procedure. After thecustomized end effector is sterilized, it can be packaged for storinguntil it is needed in a surgical procedure or can be used directly by aclinician in a surgical procedure.

A method for producing a customized end effector comprises preparing anend effector connection portion for customization. The end effectorconnection portion comprises a proximal connector configured to attachto a distal end of a surgical instrument. The proximal connectorcomprises an actuator. Once a standard connection portion is prepared,the user determines through interaction with a patient a first desiredcharacteristic of the surgical end effector and a second desiredcharacteristic of the end effector. Once the characteristics of the endeffector are determined, a first jaw member is created on the standardconnection portion having the first desired characteristic. Next, asecond jaw member is created on the standard connection portion havingthe second desired characteristic. The first and second jaw members canbe created through an additive manufacturing process, such as 3-Dprinting.

Surgical instruments can comprise devices that use mechanical energy toperform surgical procedures. Certain end effectors, such as graspingforceps can be used to grasp a target, such as the tissue of a patient,for example. Other end effectors, such as dissectors, for example, canbe used to separate and/or tear the tissue using mechanical forces.Other types of end effectors, such as electrosurgical end effectors, forexample, can use electrosurgical energy to deliver energy to the tissueof a patient and destroy and/or remove targeted tissue. These types ofsurgical instruments have been used independently of one another.

Surgical dissectors, such as the dissectors disclosed in U.S. PatentApplication Publication No. 2010/0198248, entitled SURGICAL DISSECTOR,the disclosure of which is incorporated by reference in its entirety,for example, use mechanical forces and mechanical features on the jawsof the dissector, such as teeth, for example, to manipulate a patient'stissue. The teeth can be used to stretch and/or tear a patient's tissue.Depending on the type and/or amount of tissue that a mechanicaldissector encounters, the mechanical dissector can apply various amountsof mechanical force to the tissue.

Surgical dissectors comprise a pair of jaws that are rotatable betweenopen and closed positions. Each jaw can comprise a plurality offeatures, such as teeth or ridges that can engage a patient's tissue oninner and/or outer surfaces of the jaw, for example. The features, suchas teeth, on the inner surfaces of a pair of surgical dissector jaws canbe used to gasp and/or manipulate tissue when the jaws are closed upon aportion of the patient's tissue. In addition, or in the alternative,when a pair of surgical dissector jaws comprise teeth and/or ridges onouter surfaces thereof, such teeth can increase the traction andinteraction between the jaws and the patient's tissue when the jaws aremoved into an open position, for example. As the pair of surgicaldissector jaws are opened, the teeth on the outer surfaces of the jawscan grip, stretch, and/or tear the tissue.

Electrosurgical devices for applying electrical energy to tissue inorder to treat and/or destroy the tissue are finding increasinglywidespread applications in surgical procedures. An electrosurgicaldevice typically includes a handpiece and an instrument having adistally-mounted end effector (e.g., one or more electrodes). The endeffector can be positioned against the tissue such that electricalcurrent is introduced into the tissue. Electrosurgical devices can beconfigured for bipolar and/or monopolar operation. During bipolaroperation, current is introduced into and returned from the tissue byactive and return electrodes, respectively, of the end effector. Duringmonopolar operation, current is introduced into the tissue by an activeelectrode of the end effector and returned through a return electrode(e.g., a grounding pad) separately located on a patient's body. Heatgenerated by the current flowing through the tissue may form hemostaticseals within the tissue and/or between tissues and thus may beparticularly useful for sealing blood vessels, for example. In someinstances, the voltage and current used ablates the tissue. The endeffector of an electrosurgical device also may include a cutting memberthat is movable relative to the tissue and the electrodes to transectthe tissue.

Electrical energy applied by an electrosurgical device can betransmitted to the instrument by a generator in communication with thehandpiece. The electrical energy may be in the form of radio frequency(RF) energy that may be in a frequency range described in EN60601-2-2:2009+A11:2011, Definition 201.3.218—HIGH FREQUENCY, the entiredisclosure of which is incorporated by reference. In certain instances,the frequencies in monopolar RF applications are typically restricted toless than 5 MHz, for example. However, in bipolar RF applications, thefrequency can be any suitable frequency. Frequencies above 200 kHz canbe typically used for monopolar applications in order to avoid theunwanted stimulation of nerves and muscles which would result from theuse of low frequency current, for instance. Lower frequencies may beused for bipolar techniques if the risk analysis shows the possibilityof neuromuscular stimulation has been mitigated to an acceptable level.Normally, frequencies above 5 MHz are not used in order to minimize theproblems associated with high frequency leakage currents. However,higher frequencies may be used in the case of bipolar techniques. Inmany instances, a minimum of 10 mA is needed to create thermal effectswithin the tissue.

In application, an electrosurgical device can transmit low frequency RFenergy through tissue, which causes ionic agitation, or friction—ineffect resistive heating—thereby increasing the temperature of theaffected tissue. Because a sharp boundary is created between theaffected tissue and the surrounding tissue, a surgeon can operate with ahigh level of precision and control without sacrificing un-targetedadjacent tissue. The low operating temperatures of RF energy is usefulfor removing, shrinking, and/or sculpting soft tissue whilesimultaneously sealing blood vessels. RF energy works particularly wellon connective tissue, which is primarily comprised of collagen andshrinks when contacted by heat.

Other electrical surgical instruments include, without limitation,irreversible and/or reversible electroporation, and/or microwavetechnologies, among others. The techniques disclosed herein areapplicable to ultrasonic, bipolar or monopolar RF (electrosurgical),irreversible and/or reversible electroporation, and/or microwave-basedsurgical instruments, among others. U.S. Patent Application PublicationNo. 2017/0086914 A1, to Wiener, et al., titled TECHNIQUES FOR OPERATINGGENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS ANDSURGICAL INSTRUMENTS provides examples of electrosurgical instrumentsand electrosurgical generators that can be used with the instrumentsdescribed herein, the disclosure of which is incorporated by referencein its entirety.

FIGS. 72-79 illustrate surgical instruments that comprise the mechanicalfeatures of surgical dissectors and the electrosurgical features ofelectrosurgical devices. The combination of surgical dissector andelectrosurgical instrument can allow the surgical instrumentsillustrated in FIGS. 72-79 to perform various surgical procedures. Inaddition, the combination of the mechanical and electrosurgical featuresmay allow a surgeon to perform a surgical procedure without having toswitch between different surgical instruments. As discussed in greaterdetail below with respect to FIG. 80, the combination of a mechanicaldissector and an electrosurgical instrument can provide synergisticeffects and improve the overall efficiencies and abilities of surgicalend effectors.

The embodiments disclosed in FIGS. 72-79 illustrate various end effectorjaws comprising mechanical dissector features and electrosurgical devicefeatures. These end effector jaws can be used with surgical instrumentsto deliver mechanical as well as electrical energy to a patient'stissue. The surgical instruments can comprise proximal and distal endeffector portions. The proximal portion may include a user interface,such as a handle portion and/or a connector that can connect thesurgical instrument to a robotic system, for example. The distal portionof the surgical instruments can comprise a surgical end effector. Thesurgical end effector can comprise a pair of jaws that are rotatablebetween open and closed positions. The embodiments disclosed in FIGS.72-79 illustrate an end effector jaw that can be used in a pair of jawsof a surgical end effector.

FIGS. 72-75 illustrate a surgical end effector jaw 101100 comprising aframe 101102, a metallic core 101130, and a covering 101126. The endeffector jaw 101100 comprises an inner surface 101118 and an outersurface 101108. When the end effector jaw 101100 is used in a pair ofjaws of a surgical instrument, the inner surfaces 101118 of the endeffector jaws 101100 are positioned adjacent one another. The outersurfaces, 101108 of the end effector jaw 101100 are positioned onopposite sides of the end effector jaw 101100.

The frame 101102 of the surgical end effector jaw 101100 comprises asocket 101104. When the end effector jaw 101100 is used in a pair ofjaws of a surgical instrument, the sockets 101104 of the two endeffector jaws 101100 are aligned and a pin can be inserted through thesockets 101104. The pair of end effector jaws 101100 can be rotatedabout the pin between open and closed positions. The surgical instrumentcan also comprise an actuator that can move the end effector jaws 101100between open and closed positions.

The surgical end effector jaw 101100 comprises a proximal portion 101106and a distal portion 101110. The overall geometry of the end effectorjaw 101100 is curved between the proximal portion 101106 and the distalportion 101110. In addition, the end effector jaw 101100 is tapered fromthe wider proximal portion 101106 to the narrower distal portion 101110.The tapered profile of the end effector jaw 101100 can permit a surgeonto target a specific location within a patient.

In addition, or in the alternative, the surgical end effector jaw 101100can comprise other geometries, such as a symmetrical geometry and/or anda tapered geometry with a larger distal portion 101110 and a narrowerproximal portion 101106, for example. When the surgical end effector jaw101100 comprises a symmetrical profile, the surgical end effector jaw101100 can grasp a patient's tissue evenly over the entire end effectorjaw 101100. When the surgical end effector jaw 101100 comprises atapered geometry with a larger distal portion 101110 and a narrowerproximal portion 101106, the larger distal portion 101110 can allow thesurgical end effector 101100 to grasp a larger portion of the patient'stissue.

The proximal portion 101106 of the outer surface 101108 comprises asubstantially smooth surface. The substantially smooth surface can referto a surface, for example, that is substantially free from projectionsor unevenness, generally flat or unruffled, and/or substantially ofuniform consistency. The distal portion 101110 of the outer surface101108 comprises a plurality of features. The plurality of featurescomprises central features 101120, peripheral features 101122, andlateral features 101132, and/or any other suitable features.

The central features 101120, peripheral features 101122, and lateralfeatures 101132 comprise ridges, or teeth, but could comprise anysuitable configuration. The central features 101120, peripheral features101122, and lateral features 101132 can be comprised of variousmaterials. The central, peripheral, and/or lateral features 101120,101122, 101132 can be comprised of a first material and the outersurface 101108 of the end effector jaw 101100 can be comprised of asecond material. The first material can have a greater elasticity thanthe second material. The second material can have a greater rigiditythan the first material. With a less rigid and more elastic material,the central, peripheral, and/or lateral features 101120, 101122, 101132can deform against a target, such as a patient's tissue, and increasethe traction and interaction between the surgical end effector jaw101100 and the target object.

The plurality of central features 101120 can be substantiallyperpendicular to the chord of the arc of the jaw 101108. The pluralityof central features 101120 are raised above the outer surface of the jaw101108. In addition, the central features 101120 can be overlaid orovermolded with the lateral features 101132 that can be positioned alongthe jaw 101108. The lateral features 101132 can be comprised of adifferent material having a different rigidity and elasticity. Forinstance, the lateral features 101132 can be more elastic and/or havegreater compliance than the central features 101120 which can allow thelateral features 101132 to have a greater ability to interact with atarget, such as a patient's tissue. The plurality of central features101120 can have a slight concavity with respect to the proximal portion101106 of the end effector jaw 101100, for example. The plurality ofperipheral features 101122 can include a convex shape with respect tothe proximal portion 101106 of the end effector jaw 101100, for example.The convex-concave-convex pattern of the peripheral-central-peripheralfeature combination can allow for greater interaction with a target,such as a patient's tissue.

Where the central features 101120 are aligned substantiallyperpendicular to the chord of the arc on the surgical end effector jaw101100, the central features 101120 can facilitate a desired interactionwith a patient's tissue. This configuration may allow the surgical endeffector jaw 101100 to be drawn through the tissue plane and create aparting action of the tissue. Furthermore, where the patterns of thecentral features 101120 at the tip of the surgical instrument arealigned with the chord of the arc of the surgical end effector jaw101100, this pattern facilitates the lateral movement of the surgicalend effector jaw 101100 to create a tissue parting action.

The central, peripheral, and lateral features 101120, 101122, 101132 ofthe end effector jaw 101100 can include symmetrical or asymmetricalpatterns that extend along the end effector jaw 101100. The patterns ofthe central, peripheral, and/or lateral features 101120, 101122, 101132can be continuous or interlocking and become more interrupted andstaggered as they extend towards the proximal portion 101106 and/ordistal portion 101110 of the end effector jaw 101100. The variousconfigurations of the central, peripheral, and lateral features 101120,101122, 101132 can result in posts or standing pillars that can enhancethe interaction of these features with the target object, such as apatient's tissue.

The central, peripheral, and lateral features 101120, 101122, 101132 cancomprise overmolded plastic and/or polymers. The central, peripheral,and lateral features 101120, 101122, 101132 can comprise variouspolymers or plastics having different densities and/or properties. Afirst layer of plastic may be overmolded onto portions of the metalliccore 101130 of the end effector jaw 101100. The first layer of plasticcan have a first density, rigidity, and elasticity. A second layer ofplastic may be overmolded onto portions of the first layer of overmoldedplastic and/or onto portions of the metallic core 101130. The secondlayer of plastic can have a second density, rigidity, and elasticity.The first density, rigidity, and/or elasticity can be the same ordifferent than the second density, rigidity and/or elasticity.

Various sections of the covering 101126 can comprise overmolded plasticand/or polymers. The various sections of the covering 101126 cancomprise various polymers or plastics having different densities and/orproperties. A first layer of plastics may be overmolded onto portions ofthe metallic core 101130 of the end effector jaw 101100. The first layerof plastic can have a first density, rigidity, and elasticity. A secondlayer of plastic may be overmolded onto portions of the first layer ofovermolded plastic and/or onto portions of the metallic core 101130. Thesecond layer of plastic can have a second density, rigidity, andelasticity. The first density, rigidity, and/or elasticity can be thesame or different than the second density, rigidity and/or elasticity.

In one embodiment, the first layer can comprise a rigid layer that canprovide a structural support or backbone to the end effector jaw 101100along with the metallic core 101130. The second layer can comprise amore elastic and/or less rigid layer. The second layer can be moredeformable to create a tissue interaction outer surface that allows forgrasping and securing the tissue. The first layer that is more rigid canhave a sharper profile and edges that can maintain its shape andactively shear tissue while the outer softer layer acts more like abumper to prevent cutting tissue before the surgical end effector jaw101100 is engaged with the desired location or section of tissue.

The inner surface 101118 of the end effector jaw 101100 comprises aplurality of teeth 101116 that extend between the proximal portion101106 and the distal portion 101110 of the end effector jaw 101100. Theplurality of teeth 101116 extend across the width of the inner surface101118 and follow the tapered profile of the end effector jaw 101100.The central portion of the plurality of teeth 101116 comprises anexposed section of the metallic core 101130. The exposed section of themetallic core 101130 extends substantially uniformly down the centralportion of the plurality of teeth 10116 between the proximal portion101106 and the distal portion 101110. In the alternative, the metalliccore 101130 can extend to the inner surface 101118 of the end effectorjaw 101100, for example, in an asymmetrical pattern. The differentexposed patterns of the metallic core 101130 can allow the end effectorjaw 101100 to transmit electrosurgical energy to a patient's tissue indifferent ways, as described in greater detail below.

When a patient's tissue comes in contact with the metallic core 101130,a surgeon can apply electrosurgical energy to the targeted tissuethrough the metallic core 101130. The electrosurgical energy can causeablation and/or cauterization of the targeted tissue.

The distal most portion of the inner surface 101118 comprises a distalbumper portion 101124 and a distal tip 101128. The distal bumper portion101124 comprises an elastic and/or deformable material that can allowthe end effector jaw 101100 to interact with a target object with lessirritation to the object. The distal tip 101128 comprises the metalliccore 101130 and is configured to deliver electrosurgical energy to atarget object, such as a patient's tissue. The distal bumper portion101124 being constructed of a more elastic and less rigid material canallow the user of the surgical end effector jaw 101100 to be moreaggressive without increasing the irritation of the target object, suchas a patient's tissue.

In addition, or in the alternative, the various polymers and/or plasticsthat comprise the surgical end effector jaw 101100 may comprisehydrophobic plastic or materials. The hydrophobic materials can repelliquid, such as body fluids and/or water to keep the dissection featuresfree to dissect. In addition, by repelling fluids, the hydrophobicmaterial may allow a user greater visibility of the interaction portionsof the device when using the device in a minimally invasive procedure.The hydrophobic materials may also allow for a consistent dissectionsurface during the use of the surgical instrument by repelling andkeeping away the fluids from the interaction site.

FIGS. 76-78 illustrate a surgical end effector jaw 101200 comprising aframe 101202, a metallic core 101230, and a covering 101226. The endeffector jaw 101200 comprises an inner surface 101218 and an outersurface 101208. When the end effector jaw 101200 is used in a pair ofjaws of a surgical instrument, the inner surfaces 101218 of the endeffector jaws 101200 are positioned adjacent one another. The outersurfaces 101208 of the end effector jaw 101200 are positioned onopposite sides of the end effector jaw 101200.

The frame 101202 of the surgical end effector jaw 101200 comprises asocket 101204. When the end effector jaw 101200 is used in a pair ofjaws of a surgical instrument, the sockets 101204 of the two endeffector jaws 101200 are aligned and a pin can be inserted through thesockets 101204. The pair of end effector jaws 101200 can be rotatedabout the pin between open and closed positions. The surgical instrumentcan also comprise an actuator that can move the end effector jaws 101200between open and closed positions.

The surgical end effector jaw 101200 comprises a proximal portion 101206and a distal portion 101210. The overall geometry of the end effectorjaw 101200 is curved between the proximal portion 101206 and the distalportion 101210. In addition, the end effector jaw 101200 is tapered fromthe wider proximal portion 101206 to the narrower distal portion 101210.The tapered profile of the end effector jaw 101200 can permit a surgeonto target a specific location within a patient.

In addition, or in the alternative, the surgical end effector jaw 101200can comprise other geometries, such as a symmetrical geometry and/or anda tapered geometry with a larger distal portion 101210 and a narrowerproximal portion 101206, for example. When the surgical end effector jaw101200 comprises a symmetrical profile, the surgical end effector jaw101200 can grasp a patient's tissue evenly over the entire end effectorjaw 101200. When the surgical end effector jaw 101200 comprises atapered geometry with a larger distal portion 101210 and a narrowerproximal portion 101206, the larger distal portion 101210 can allow thesurgical end effector 101200 to grasp a larger portion of the patient'stissue.

The proximal portion 101206 of the outer surface 101208 comprises asubstantially smooth surface. The substantially smooth surface can referto a surface, for example, that is substantially free from projectionsor unevenness, generally flat or unruffled, and/or substantially ofuniform consistency. The distal portion 101210 of the outer surface101208 comprises a plurality of features. The plurality of featurescomprises central features 101220, peripheral features 101222, andlateral features 101232, and/or any other suitable features.

The central features 101220, peripheral features 101222, and lateralfeatures 101232 comprise recesses or through holes, but could compriseany suitable configuration. The recesses or through holes expose themetallic core 101230 to the outer surface 101208 and patient tissue. Thecentral features 101220, peripheral features 101122, and lateralfeatures 101232 can comprise different diameters and/or depths, or thesame diameters and/or depths. The central features 101220, peripheralfeatures 101122, and lateral features 101232 can also comprise differentpatterns and/or orientations along the outer surface 101208 of thesurgical end effector jaw 101200.

The central features 101220, peripheral features 101222, and lateralfeatures 101232 allow a patient's tissue to come in contact with themetallic core 101230 of the surgical end effector jaw 101200. When apair of end effector jaws 101200 is used to stretch out tissue, themechanical forces used to stretch out the tissue can cause the tissue toflow into the central features 101220, peripheral features 101222,and/or lateral features 101232. Once the tissue is in contact with themetallic core 101230 within the central features 101220, peripheralfeatures 101222, and/or lateral features 101232, a clinician can applyelectrosurgical energy to the tissue. The combination of mechanicalforce and electrosurgical energy can allow for ablation of the tissuewithout tearing the tissue. In addition, or in the alternative, theelectrosurgical energy can allow the end effector jaws 101200 tocauterize the tissue as the tissue is spread and/or torn. Thecombination of electrosurgical energy and mechanical forces can allow asurgeon to perform a surgical procedure with using less mechanical forceas the effects of the electrosurgical energy and mechanical force arecumulative.

In various instances, less mechanical force, for example, is required todissect tissue when more electrosurgical energy is applied.Correspondingly, more mechanical force is required to dissect tissuewhen less electrosurgical energy is applied. That said, the ratio ofmechanical force to electrosurgical energy can be held constantthroughout the opening stroke of the dissector jaws. In other instances,the ratio of mechanical force to electrosurgical energy can changethroughout the opening stroke of the dissector jaws. In at lease oneinstance, the electrosurgical energy can increase as the dissector jawsare opened. Such an arrangement can apply the electrosurgical energywhen tissue tearing and/or bleeding is most likely to occur. In otherinstances, the electrosurgical energy can decrease as the dissector jawsare opened. Such an arrangement can create or start an initial otomythat then is stretched open by the mechanical force.

The inner surface 101218 of the end effector jaw 101200 comprises aplurality of teeth 101216 that extend between the proximal portion101206 and the distal portion 101210 of the end effector jaw 101200. Theplurality of teeth 101216 extend across the width of the inner surface101218 and follow the tapered profile of the end effector jaw 101200.The central portion of the plurality of teeth 101216 comprises anexposed section of the metallic core 101230. The exposed section of themetallic core 101230 extends substantially uniformly down the centralportion of the plurality of teeth 10126 between the proximal portion101206 and the distal portion 101210. In the alternative, the metalliccore 101230 can extend to the inner surface 101218 of the end effectorjaw 101200, for example, in an asymmetrical pattern. The differentexposed patterns of the metallic core 101230 can allow the end effectorjaw 101200 to transmit electrosurgical energy to a patient's tissue indifferent ways, as described in greater detail below.

When a patient's tissue comes in contact with the metallic core 101230,a surgeon can apply electrosurgical energy to the targeted tissuethrough the metallic core 101230. The electrosurgical energy can causeablation and/or cauterization of the targeted tissue.

The distal most portion of the inner surface 101218 comprises a distalbumper portion 101224 and a distal tip 101228. The distal bumper portion101224 comprises an elastic and/or deformable material that can allowthe end effector jaw 101200 to interact with a target object with lessirritation to the object. The distal tip 101228 comprises the metalliccore 101230 and is configured to deliver electrosurgical energy to atarget object, such as a patient's tissue. The distal bumper portion101224 being constructed of a more elastic and less rigid material canallow the user of the surgical end effector jaw 101200 to be moreaggressive without increasing the irritation of the target object, suchas a patient's tissue.

Various sections of the covering 101226 can comprise overmolded plasticand/or polymers. The various sections of the covering 101226 cancomprise various polymers or plastics having different densities and/orproperties. A first layer of plastics may be overmolded onto portions ofthe metallic core 101230 of the end effector jaw 101200. The first layerof plastic can have a first density, rigidity, and elasticity. A secondlayer of plastic may be overmolded onto portions of the first layer ofovermolded plastic and/or onto portions of the metallic core 101230. Thesecond layer of plastic can have a second density, rigidity, andelasticity. The first density, rigidity, and/or elasticity can be thesame or different than the second density, rigidity and/or elasticity.

In addition, or in the alternative, the various polymers and/or plasticsthat comprise the surgical end effector jaw 101200 may comprisehydrophobic plastic or materials. The hydrophobic materials can repelliquid, such as body fluids and/or water to keep the dissection featuresfree to dissect. In addition, by repelling fluids, the hydrophobicmaterial may allow a user greater visibility of the interaction portionsof the device when using the device in a minimally invasive procedure.The hydrophobic materials may also allow for a consistent dissectionsurface during the use of the surgical instrument by repelling andkeeping away the fluids from the interaction site.

FIG. 79 illustrates an embodiment similar to the end effector 101300,discussed above. The end effector 101300 includes a central distalfeature 101336 and lateral distal features 101334 that are positioned onthe distal nose of the end effector jaw 101300. The central distalfeature 101336 and lateral distal features 101334 comprise recesses orthrough holes. The recesses or through holes expose the metallic core101330 to the outer surface 101308. The central distal feature 101336and lateral distal features 101334 can comprise different diametersand/or depths, or the same diameters and/or depths. The central distalfeature 101336 and lateral distal features 101334 can also comprisedifferent patterns and/or orientations along the outer surface 101308 ofthe surgical end effector jaw 101300.

The central distal feature 101336 and lateral distal features 101334allow a patient's tissue to come in contact with the metallic core101330 of the surgical end effector jaw 101300. When a surgeon pushestissue with the nose of the surgical end effector jaw 101300, themechanical forces used to push the jaw 101300 into the tissue to stretchout the tissue can cause the tissue to flow into the central distalfeature 101336 and lateral distal features 101334. Once the tissue is incontact with the metallic core 101330 within the central distal feature101336 and/or lateral distal features 101334, electrosurgical energy canbe transmitted to the tissue. The combination of mechanical force andelectrosurgical energy can allow for ablation of the tissue withouttearing the tissue. In addition, or in the alternative, theelectrosurgical energy can allow the end effector jaws 101300 tocauterize the tissue as the tissue is spread and/or torn. Thecombination of electrosurgical energy and mechanical forces can allow asurgeon to perform a surgical procedure with using less mechanical forceas the effects of the electrosurgical energy and mechanical force arecumulative.

In various instances, less mechanical force, for example, is required todissect tissue when more electrosurgical energy is applied.Correspondingly, more mechanical force is required to dissect tissuewhen less electrosurgical energy is applied. That said, the ratio ofmechanical force to electrosurgical energy can be held constantthroughout the opening stroke of the dissector jaws. In other instances,the ratio of mechanical force to electrosurgical energy can changethroughout the opening stroke of the dissector jaws. In at lease oneinstance, the electrosurgical energy can increase as the dissector jawsare opened. Such an arrangement can apply the electrosurgical energywhen tissue tearing and/or bleeding is most likely to occur. In otherinstances, the electrosurgical energy can decrease as the dissector jawsare opened. Such an arrangement can create or start an initial otomythat then is stretched open by the mechanical force.

The surgical end effector jaws may also have overmolded plastic bodieshaving fractal exterior geometries. The fractal exterior geometries canenable the distal tip of the end effector jaws to be more aggressivewithout creating undesired interaction with the tissue. In anotherembodiment, the metallic core of the end effector jaws can be positionednear the outer surface and at the distal tip as well as along the spineof the surgical end effector, as seen in FIGS. 76-79. The metallic coremay be exposed to the tissue through the various features and recessesalong the end effector jaw's outer surface. The metallic core may berecessed within 0.0001-0.001 mm of the outer surface and in electricalcontact with the shaft of the surgical instrument to permit thetransmission of electrosurgical energy along the end effector jaw. Withthe metallic core exposed to the tissue, the metallic core can deliverelectrosurgical energy to the patient's tissue. In this configuration,the surgical instrument may operate as a hybrid between a mechanicalsurgical dissector and an electrosurgical instrument.

The various features and characteristics described with regard to thesurgical instruments and end effectors illustrated in FIGS. 58-79 can becomprised of various materials. The end effectors illustrated in FIGS.72-79 can comprise a metallic core that can deliver electrosurgicalenergy from an electrosurgical instrument to a patient's tissue. Thevarious features described above can comprise overmolded plastic orpolymers. The features can comprise polymers or plastics having variousdensities and properties. A first layer of plastics may be overmoldedonto portions of the metallic core of the end effector. The first layerof plastic can have a first density, rigidity, and elasticity. A secondlayer of plastics may be overmolded onto portions of the first layer ofovermolded plastic and/or onto portions of the metallic core. The secondlayer of plastic can have a second density, rigidity, and elasticity.The first density, rigidity and/or elasticity can be the same ordifferent than the second density, rigidity and/or elasticity.

In one embodiment, the first layer can comprise a rigid layer that canprovide a structural support or backbone to the end effector. The secondlayer can comprise a more elastic and less rigid layer. The second layercan be more deformable to create a tissue interaction outer surface thatallows for grasping and securing the tissue. The first layer that ismore rigid can have a sharper profile and edges that can maintain itsshape and actively shear tissue while the outer softer layer acts morelike a bumper to prevent cutting tissue before the surgical end effectoris engaged with the desired portion or section of tissue.

The surgical instruments illustrated in FIGS. 72-79 can be producedthrough traditional manufacturing processes. In addition, or in thealternative, the surgical instruments illustrated in FIGS. 72-79 can beproduced through the additive manufacturing procedures discussed abovewith respect to FIGS. 58-71. The surgical instruments of FIGS. 72-79 cancomprise a metallic core and the outer shape and features of the endeffectors can be produced through an additive manufacturing process toproduce customized surgical end effectors having desired features and/orshapes.

As discussed above, with regard to FIGS. 72-79, surgical end effectorjaws can be used to employ a combination of electrosurgical andmechanical forces to effected tissue. FIG. 80 illustrates a graphicalrepresentation 101400 of the relationship between various parameters fora surgical instrument having mechanical and electrosurgical features.The various parameters include the current delivered to the tissue101402, the voltage to current ratio 101404, the impedance of the tissuebeing treated 101406, and the mechanical force being applied to thetissue 101408. The various parameters are illustrated with a referenceto various aspects of a surgical procedure, such as a dissectionprocedure 101410, for example. The dissection procedure 101410 includesan initial force loading condition 101412, a tissue spreading condition101414, and a force unloading condition 101416.

During the initial force loading condition 101412, the current deliveredto the tissue 101402, the voltage to current ratio 101404, and theimpedance of the tissue being treated 101406 initially increase. Overthe initial force loading condition 101412, the current delivered to thetissue 101402 and the voltage to current ratio 101404 continue toincrease while the impedance of the tissue being treated 101406decreases and then levels out. The mechanical force being applied to thetissue 101408 also increases over the initial force loading condition101412. As the mechanical force being applied to the tissue 101408increase, the surgical end effector jaws begin to push layers of thetissue away.

Once the initial force loading condition 101412 is completed, the tissuespreading condition 101414 occurs. Over a first stage of the tissuespreading condition 101414, the current delivered to the tissue 101402and the impedance of the tissue being treated 101406 remain relativelysteady while the voltage to current ratio 101404 fluctuates. Inaddition, over the first stage of the tissue spreading condition 101414,the mechanical force being applied to the tissue 101408 increases andbegins to exceed a higher reinforcement threshold. When the higherreinforcement threshold is exceeded, the current delivered to the tissue101402 and the voltage to current ratio 101404 are increased toreinforce the tissue spreading, which in turn reduces the impedance ofthe tissue being treated 101406. The mechanical force being applied tothe tissue 101408 by the end effector jaws drop due to the assistance ofthe electrosurgical energy, as such, the levels for the currentdelivered to the tissue 101402 and the voltage to current ratio 101404are reduced. When the mechanical force being applied to the tissue101408 falls below a lower reinforcement threshold, the currentdelivered to the tissue 101402 and the voltage to current ratio 101404are reduced as the need for reinforcement assistance from theelectrosurgical aspects of the surgical instrument are reduced. Once themechanical force being applied to the tissue 101408 climbs above thelower reinforcement threshold, the current delivered to the tissue101402 and the voltage to current ratio 101404 return to their previouslevels.

After the tissue spreading condition 101414 occurs, the mechanicalforces and electrosurgical energy being applied are reduced asrepresented by the unloading condition 101416. During the forceunloading condition 101416, the current delivered to the tissue 101402,the voltage to current ratio 101404, the impedance of the tissue beingtreated 101406, and the mechanical force being applied to the tissue101408 are all reduced to the initial unloaded condition. Thecombination of the mechanical force being applied to the tissue 101408and electrosurgical energy allows the surgical instrument to perform thesurgical procedure using less mechanical energy which can result in lesstearing of the tissue. The application of the electrosurgical energy canalso seal the tissue as it is being separated by the opening of the endeffector jaws.

To detect the various threshold levels, discussed above, a surgicalinstrument may have sensors to monitor the pressures, currents,voltages, impedance of the tissue, and forces applied during a surgicalprocedure and modify the parameters to prevent any of the threshold frombeing exceeded. In addition, or in the alternative, a surgeon may beprovided with tactical feedback regarding the parameters and manuallycontrol the various parameters.

A surgical system 128000 is illustrated in FIG. 80. The surgical system128000 comprises a handle, a shaft 128020 extending from the handle, andan end effector 128030 extending from the shaft 128020. In alternativeembodiments, the surgical system 128000 comprises a housing configuredto be mounted to a robotic surgical system. In at least one suchembodiment, the shaft 128020 extends from the robotic housing mountinstead of the handle. In either event, the end effector 128030comprises jaws 128040 and 128050 which are closeable to grasp a target,such as the tissue T of a patient and/or a suture needle, for example,as discussed in greater detail below. The jaws 128040 and 128050 arealso openable to dissect the tissue of a patient, for example. In atleast one instance, the jaws 128040 and 128050 are insertable into thepatient tissue to create an otomy therein and then spread to open theotomy, as discussed in greater detail below.

Referring again to FIG. 80, the jaws 128040 and 128050 are pivotablycoupled to the shaft 128020 about a pivot joint 128060. The pivot joint128060 defines a fixed axis of rotation, although any suitablearrangement could be used. The jaw 128040 comprises a distal end, ortip, 128041 and an elongate profile which narrows from its proximal endto its distal end 128041. Similarly, the jaw 128050 comprises a distalend, or tip, 128051 and an elongate profile which narrows from itsproximal end to its distal end 128051. The distance between the tips128041 and 128051 define the mouth width, or opening, 128032 of the endeffector 128030. When the tips 128041 and 128051 are close to oneanother, or in contact with one another, the mouth 128032 is small, orclosed, and the mouth angle θ is small, or zero. When the tips 128041and 128051 are far apart, the mouth 128032 is large and the mouth angleθ is large.

Further to the above, the jaws of the end effector 128030 are driven bya jaw drive system including an electric motor. In use, a voltagepotential is applied to the electric motor to rotate the drive shaft ofthe electric motor and drive the jaw drive system. The surgical system128000 comprises a motor control system configured to apply the voltagepotential to the electric motor. In at least one instance, the motorcontrol system is configured to apply a constant DC voltage potential tothe electric motor. In such instances, the electric motor will run at aconstant speed, or an at least substantially constant speed. In variousinstances, the motor control system comprises a pulse width modulation(PWM) circuit and/or a frequency modulation (FM) circuit which can applyvoltage pulses to the electric motor. The PWM and/or FM circuits cancontrol the speed of the electric motor by controlling the frequency ofthe voltage pulses supplied to the electric motor, the duration of thevoltage pulses supplied to the electric motor, and/or the durationbetween the voltage pulses supplied to the electric motor.

The motor control system is also configured to monitor the current drawnby the electric motor as a means for monitoring the force being appliedby the jaws of the end effector 128030. When the current being drawn bythe electric motor is low, the loading force on the jaws is low.Correspondingly, the loading force on the jaws is high when the currentbeing drawn by the electric motor is high. In various instances, thevoltage being applied to the electric motor is fixed, or held constant,and the motor current is permitted to fluctuate as a function of theforce loading at the jaws. In certain instances, the motor controlsystem is configured to limit the current drawn by the electric motor tolimit the force that can be applied by the jaws. In at least oneembodiment, the motor control system can include a current regulationcircuit that holds constant, or at least substantially constant, thecurrent drawn by the electric motor to maintain a constant loading forceat the jaws.

The force generated between the jaws of the end effector 128030, and/oron the jaws of the end effector 128030, may be different depending onthe task that the jaws are being used to perform. For instance, theforce needed to hold a suture needle may be high as suture needles aretypically small and it is possible that a suture needle may slip duringuse. As such, the jaws of the end effector 128030 are often used togenerate large forces when the jaws are close together. On the otherhand, the jaws of the end effector 128030 are often used to applysmaller forces when the jaws are positioned further apart to performlarger, or gross, tissue manipulation, for example.

Referring to the upper portion 128110 of the graph 128100 illustrated inFIG. 81, the loading force, f, experienced by the jaws of the endeffector 128030 can be limited by a force profile stored in the motorcontrol system. The force limit profile 128110 o for opening the jaws128040 and 128050 is different than the force limit profile 128110 c forclosing the jaws 128040 and 128050. This is because the proceduresperformed when forcing the jaws 128040 and 128050 open are typicallydifferent than the procedures performed when forcing the jaws 128040 and128050 closed. That said, the opening and closing force limit profilescould be the same. While it is likely that the jaws 128040 and 128050will experience some force loading regardless of whether the jaws 128050are being opened or closed, the force limit profiles typically come intoplay when the jaws 128040 and 128050 are being used to perform aparticular procedure within the patient. For instance, the jaws 128040and 128050 are forced open to create and expand an otomy in the tissueof a patient, as represented by graph sections 128115 and 128116,respectively, of graph 128100, while the jaws 128040 and 128050 areforced closed to grasp a needle and/or the patient tissue, asrepresented by graph sections 128111 and 128112, respectively, of graph128100.

Referring again to FIG. 81, the opening and closing jaw force limitprofiles 128110 o and 128110 c, respectively, are depicted on theopposite sides of a zero force line depicted in the graph 128100. As canbe seen in the upper section 128110 of graph 128100, the jaw force limitthreshold is higher—for both force limit profiles 128110 o and 128110c—when the jaws 128040 and 128050 are just being opened from theirfully-closed position. As can also be seen in the upper section 128110of graph 128100, the jaw force limit threshold is lower—for both forcelimit profiles 128110 o and 128110 c—when the jaws 128040 and 128050 arereaching their fully-opened position. Such an arrangement can reduce thepossibility of the jaws 128040 and 128050 damaging adjacent tissue whenthe being fully opened, for example. In any event, the force that thejaws 128040 and 128050 are allowed to apply is a function of the mouthopening size between the jaws and/or the direction in which the jaws arebeing moved. For instance, when the jaws 128040 and 128050 are openedwidely, or at their maximum, to grasp large objects, referring to graphsection 128114 of upper graph section 128110, the jaw force f limit isvery low as compared to when the jaws 128040 and 128050 are more closedto perform gross tissue manipulation, referring to graph section 128113of upper graph section 128110. Moreover, different jaw force limitprofiles can be used for different jaw configurations. For instance,Maryland dissectors, which have narrow and pointy jaws, may have adifferent jaw force limit profile than a grasper having blunt jaws, forexample.

In addition to or in lieu of the above, the speed of the jaws 128040 and128050 can be controlled and/or limited by the motor control system as afunction of the mouth opening size between the jaws 128040 and 128050and/or the direction the jaws are being moved. Referring to the middleportion 128120 and lower portion 128130 of the graph 128100 in FIG. 81,the rate limit profile for moving the jaws 128040 and 128050 permits thejaws to be moved slowly when the jaws are near their closed position andmoved quickly when the jaws are near their open position. In suchinstances, the jaws 128040 and 128050 are accelerated as the jaws areopened. Such an arrangement can provide fine control over the jaws128040 and 128050 when they are close together to facilitate the finedissection of tissue, for example. Notably, the rate limit profile foropening and closing the jaws 128040 and 128050 is the same, but theycould be different in other embodiments. In alternative embodiments, therate limit profile for moving the jaws 128040 and 128050 permits thejaws to be moved quickly when the jaws are near their closed positionand slowly when the jaws are near their open position. In suchinstances, the jaws 128040 and 128050 are decelerated as the jaws areopened. Such an arrangement can provide fine control over the jaws128040 and 128050 when the jaws are being used to stretch an otomy, forexample. The above being said, the speed of the jaws 128040 and 128050can be adjusted once the jaws experience loading resistance from thepatient tissue, for example. In at least one such instance, the jawopening rate and/or the jaw closing rate can be reduced once the jaws128040 and 128050 begin to experience force resistance above athreshold, for example.

In various instances, further to the above, the handle of the surgicalsystem 128000 comprises an actuator, the motion of which tracks, or issupposed to track, the motion of the jaws 128040 and 128050 of the endeffector 128030. For instance, the actuator can comprise a scissors-gripconfiguration which is openable and closable to mimic the opening andclosing of the end effector jaws 128040 and 128050. The control systemof the surgical system 128000 can comprise one or more sensor systemsconfigured to monitor the state of the end effector jaws 128040 and128050 and the state of the handle actuator and, if there is adiscrepancy between the two states, the control system can take acorrective action once the discrepancy exceeds a threshold and/orthreshold range. In at least one instance, the control system canprovide feedback, such as audio, tactile, and/or haptic feedback, forexample, to the clinician that the discrepancy exists and/or provide thedegree of discrepancy to the clinician. In such instances, the cliniciancan make mental compensations for this discrepancy. In addition to or inlieu of the above, the control system can adapt its control program ofthe jaws 128040 and 128050 to match the motion of the actuator. In atleast one instance, the control system can monitor the loading forcebeing applied to the jaws and align the closed position of the actuatorwith the position of the jaws when the jaws experience the peak forceloading condition when grasping tissue. Similarly, the control systemcan align the open position of the actuator with the position of thejaws when the jaws experience the minimum force loading condition whengrasping tissue. In various instances, the control system is configuredto provide the clinician with a control to override these adjustmentsand allow the clinician to use their own discretion in using thesurgical system 128000 in an appropriate manner.

A surgical system 128700 is illustrated in FIGS. 82 and 83. The surgicalsystem 128700 comprises a handle, a shaft assembly 128720 extending fromthe handle, and an end effector 128730 extending from the shaft assembly128720. In alternative embodiments, the surgical system 128700 comprisesa housing configured to be mounted to a robotic surgical system. In atleast one such embodiment, the shaft 128720 extends from the robotichousing mount instead of the handle. In either event, the end effector128730 comprises shears configured to transect the tissue of a patient.The shears comprise two jaws 128740 and 128750 configured to transectthe patient tissue positioned between the jaws 128740 and 128750 as thejaws 128740 and 128750 are being closed. Each of the jaws 128740 and128750 comprises a sharp edge configured to cut the tissue and arepivotably mounted to the shaft 128720 about a pivot joint 128760. Suchan arrangement can comprise bypassing scissors shears. Other embodimentsare envisioned in which one of the jaws 128740 and 128750 comprises aknife edge and the other comprises a mandrel against the tissue issupported and transected. Such an arrangement can comprise a knife wedgein which the knife wedge is moved toward the mandrel. In at least oneembodiment, the jaw comprising the knife edge is movable and the jawcomprising the mandrel is stationary. The above being said, embodimentsare envisioned in which the tissue-engaging edges of one or both of thejaws 128740 and 128750 are not necessarily sharp.

As discussed above, the end effector 128730 comprises two scissor jaws128740 and 128750 movable between an open position and a closed positionto cut the tissue of a patient. The jaw 128740 comprises a sharp distalend 128741 and the jaw 128750 comprises a sharp distal end 128751 whichare configured to snip the tissue of the patient at the mouth 128731 ofthe end effector 128730, for example. That said, other embodiments areenvisioned in which the distal ends 128741 and 128751 are blunt and canbe used to dissect tissue, for example. In any event, the jaws aredriven by a jaw drive system including an electric drive motor, thespeed of which is adjustable to adjust the closure rate and/or openingrate of the jaws. Referring to the graph 128400 of FIG. 84, the controlsystem of the surgical system is configured to monitor the loading, orshear, force on the jaws 128740 and 128750 as the jaws 128740 and 128750are being closed and adaptively slow down the drive motor when largeforces, or forces above a threshold Fc, are experienced by the jaws128740 and 128750. Such large forces often occur when the tissue T beingcut by the jaws 128740 and 128750 is thick, for example. Similar to theabove, the control system can monitor the current drawn by the drivemotor as a proxy for the loading force being experienced by the jaws128740 and 128750. In addition to or in lieu of this approach, thecontrol system can be configured to measure the jaw loading forcedirectly by one or more load cells and/or strain gauges, for example.Once the loading force experienced by the jaws 128740 and 128750 dropsbelow the force threshold Fc, the control system can adaptively speed upthe jaw closure rate. Alternatively, the control system can maintain thelower closure rate of the jaws 128740 and 128750 even though the forcethreshold is no longer being exceeded.

The above-provided discussion with respect to the surgical system 128700can provide mechanical energy or a mechanical cutting force to thetissue of a patient. That said, the surgical system 128700 is alsoconfigured to provide electrosurgical energy or an electrosurgicalcutting force to the tissue of a patient. In various instances, theelectrosurgical energy comprises RF energy, for example; however,electrosurgical energy could be supplied to the patient tissue at anysuitable frequency. In addition to or in lieu of AC power, the surgicalsystem 128700 can be configured to supply DC power to the patienttissue. The surgical system 128700 comprises a generator in electricalcommunication with one or more electrical pathways defined in theinstrument shaft 128720 which can supply electrical power to the jaws128740 and 128750 and also provide a return path for the current. In atleast one instance, the jaw 128740 comprises an electrode 128742 inelectrical communication with a first electrical pathway in the shaft128720 and the jaw 128750 comprises an electrode 128752 in electricalcommunication with a second electrical pathway in the shaft 128720. Thefirst and second electrical pathways are electrically insulated, or atleast substantially insulated, from one another and the surroundingshaft structure such that the first and second electrical pathways, theelectrodes 128742 and 128752, and the tissue positioned between theelectrodes 128742 and 128752 forms a circuit. Such an arrangementprovides a bipolar arrangement between the electrodes 128742 and 128752.That said, embodiments are envisioned in which a monopolar arrangementcould be used. In such an arrangement, the return path for the currentgoes through the patient and into a return electrode positioned on orunder the patient, for example.

As discussed above, the tissue of a patient can be cut by using amechanical force and/or an electrical force. Such mechanical andelectrical forces can be applied simultaneously and/or sequentially. Forinstance, both forces can be applied at the beginning of a tissuecutting actuation and then the mechanical force can be discontinued infavor of the electrosurgical force finishing the tissue cuttingactuation. Such an approach can apply an energy-created hemostatic sealto the tissue after the mechanical cutting has been completed. In sucharrangements, the electrosurgical force is applied throughout theduration of the tissue cutting actuation. In other instances, themechanical cutting force, without the electrosurgical cutting force, canbe used to start a tissue cutting actuation which is then followed bythe electrosurgical cutting force after the mechanical cutting force hasbeen stopped. In such arrangements, the mechanical and electrosurgicalforces are not overlapping or co-extensive. In various instances, boththe mechanical and electrosurgical forces are overlapping andco-extensive throughout the entire tissue cutting actuation. In at leastone instance, both forces are overlapping and co-extensive throughoutthe entire tissue cutting actuation but in magnitudes or intensitiesthat change during the tissue cutting actuation. The above being said,any suitable combination, pattern, and/or sequence of mechanical andelectrosurgical cutting forces and energies could be used.

Further to the above, the surgical system 128700 comprises a controlsystem configured to co-ordinate the application of the mechanical forceand electrosurgical energy to the patient tissue. In various instances,the control system is in communication with the motor controller whichdrives the jaws 128740 and 128750 and, also, the electrical generatorand comprises one or more sensing systems for monitoring the mechanicalforce and electrosurgical energy being applied to the tissue. Systemsfor monitoring the forces within a mechanical drive system are disclosedelsewhere herein. Systems for monitoring the electrosurgical energybeing applied to the patient tissue include monitoring the impedance, orchanges in the impedance, of the patient tissue via the electricalpathways of the electrosurgical circuit. In at least one instance,referring to the graph 128800 in FIG. 85, the RF current/voltage ratioof the electrosurgical power being applied to the patient tissue by thegenerator is evaluated by monitoring the current and voltage of thepower being supplied by the generator. The impedance of the tissue andthe RF current/voltage ratio of the electrosurgical power are a functionof many variables such as the temperature of the tissue, the density ofthe tissue, the thickness of the tissue, the type of tissue between thejaws 128740 and 128750, the duration in which the power is applied tothe tissue, among others, which change throughout the application of theelectrosurgical energy.

Further to the above, the control system and/or generator of thesurgical system 128700 comprises one or more ammeter circuits and/orvoltmeter circuits configured to monitor the electrosurgical currentand/or voltage, respectively, being applied to the patient tissue.Referring again to FIG. 85, a minimum amplitude limit and/or a maximumamplitude limit on the current being applied to the patient tissue canbe preset in the control system and/or can be controllable by the userof the surgical instrument system through one or more input controls.The minimum and maximum amplitude limits can define a current envelopewithin which the electrosurgical portion of the surgical system 128700is operated.

In various instances, the control system of the surgical system 128700is configured to adaptively increase the electrosurgical energy appliedto the patient tissue when the drive motor slows. The motor slowing canbe a reaction to an increase in the tissue cutting load and/or anadaptation of the control system. Similarly, the control system of thesurgical system 128700 is configured to adaptively increase theelectrosurgical energy applied to the patient tissue when the drivemotor stops. Again, the motor stopping can be a reaction to an increasein the tissue cutting load and/or an adaptation of the control system.Increasing the electrosurgical energy when the electric motor slowsand/or stops can compensate for a reduction in mechanical cuttingenergy. In alternative embodiments, the electrosurgical energy can bereduced and/or stopped when the electric motor slows and/or stops. Suchembodiments can afford the clinician to evaluate the situation in alow-energy environment.

In various instances, the control system of the surgical system 128700is configured to adaptively decrease the electrosurgical energy appliedto the patient tissue when the drive motor speeds up. The motor speedingup can be a reaction to a decrease in the cutting load and/or anadaptation of the control system. Decreasing the electrosurgical energywhen the electric motor slows and/or stops can compensate for, orbalance out, an increase in mechanical cutting energy. In alternativeembodiments, the electrosurgical energy can be increased when theelectric motor speeds up. Such embodiments can accelerate the closure ofthe jaws and provide a clean, quick cutting motion.

In various instances, the control system of the surgical system 128700is configured to adaptively increase the speed of the drive motor whenthe electrosurgical energy applied to the patient tissue decreases. Theelectrosurgical energy decreasing can be a reaction to a change intissue properties and/or an adaptation of the control system. Similarly,the control system of the surgical system 128700 is configured toadaptively increase the speed of the drive motor when electrosurgicalenergy applied to the patient tissue stops in response to an adaptationof the control system. Increasing the speed of the drive motor when theelectrosurgical energy decreases or is stopped can compensate for areduction in electrosurgical cutting energy. In alternative embodiments,the speed of the drive motor can be reduced and/or stopped when theelectrosurgical energy decreases and/or is stopped. Such embodiments canafford the clinician to evaluate the situation in a low-energy and/orstatic environment.

In various instances, the control system of the surgical system 128700is configured to adaptively decrease the speed of the electric motorwhen the electrosurgical energy applied to the patient tissue increases.The electrosurgical energy increasing can be a reaction to a change intissue properties and/or an adaptation of the control system. Decreasingthe drive motor speed when the electrosurgical energy increases cancompensate for, or balance out, an increase in electrosurgical cuttingenergy. In alternative embodiments, the drive motor speed can beincreased when the electrosurgical energy increases. Such embodimentscan accelerate the closure of the jaws and provide a clean, quickcutting motion.

In various instances, the surgical system 128700 comprises controls,such as on the handle of the surgical system 128700, for example, that aclinician can use to control when the mechanical and/or electrosurgicalforces are applied. In addition to or in lieu of manual controls, thecontrol system of the surgical system 128700 is configured to monitorthe mechanical force and electrical energy being applied to the tissueand adjust one or the other, if needed, to cut the tissue in a desirablemanner according to one or more predetermined force-energy curves and/ormatrices. In at least one instance, the control system can increase theelectrical energy being delivered to the tissue once the mechanicalforce being applied reaches a threshold limit. Moreover, the controlsystem is configured to consider other parameters, such as the impedanceof the tissue being cut, when making adjustments to the mechanical forceand/or electrical energy being applied to the tissue.

The surgical instrument systems described herein are motivated by anelectric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In certain instances,the motors disclosed herein may comprise a portion or portions of arobotically controlled system. U.S. patent application Ser. No.13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example,discloses several examples of a robotic surgical instrument system ingreater detail, the entire disclosure of which is incorporated byreference herein.

The surgical instrument systems described herein can be used inconnection with the deployment and deformation of staples. Variousembodiments are envisioned which deploy fasteners other than staples,such as clamps or tacks, for example. Moreover, various embodiments areenvisioned which utilize any suitable means for sealing tissue. Forinstance, an end effector in accordance with various embodiments cancomprise electrodes configured to heat and seal the tissue. Also, forinstance, an end effector in accordance with certain embodiments canapply vibrational energy to seal the tissue. In addition, variousembodiments are envisioned which utilize a suitable cutting means to cutthe tissue.

EXAMPLES Example 1

A surgical end effector for use with a surgical instrument. The surgicalend effector comprises a proximal connector configured to attach to adistal end of the surgical instrument. The proximal connector comprisesan actuator. The surgical end effector further comprises a first jawmember. The first jaw member comprises a first portion comprising afirst feature, and a second portion comprising a second feature. Thesurgical end effector further comprises a second jaw member. At leastone of the first jaw member and the second jaw member is movablerelative to the other one of the first jaw member and the second jawmember between an open configuration and a closed configuration. Thesecond jaw member comprises a first portion comprising a first feature,and a second portion comprising a second feature. At least one of thefirst feature of the first jaw member and the first feature of thesecond jaw member is selected by a user in an additive manufacturingprocess.

Example 2

The surgical end effector of Example 1, wherein the additivemanufacturing process comprises 3-D printing.

Example 3

The surgical end effector of Examples 1 or 2, wherein the first jawmember comprises an inner surface and an outer surface, wherein thesecond jaw member comprises an inner surface and an outer surface, andwherein the inner surface of the first jaw member and the inner surfaceof the second jaw member comprise a mating relationship when thesurgical end effector is in the closed configuration.

Example 4

The surgical end effector of Examples 1, 2, or 3, wherein the firstfeature of the first jaw member comprises a tooth, wherein the firstfeature of the second jaw member comprises a void, and wherein, when thesurgical end effector is in the closed configuration, the tooth isreceived in the void.

Example 5

The surgical end effector of Examples 1, 2, 3, or 4, wherein the firstfeature of the first jaw member comprises a first material, wherein thesecond feature of the first jaw member comprises a second material, andwherein the first material is different than the second material.

Example 6

The surgical end effector of Examples 1, 2, 3, or 4, wherein the firstfeature of the first jaw member comprises a first material, wherein thefirst feature of the second jaw member comprises a second material, andwherein the first material is different than the second material.

Example 7

The surgical end effector of Examples 1, 2, 3, 4, 5, or 6, wherein thefirst feature of the first jaw member comprises a first symmetricalpattern of protrusions, wherein the first feature of the second jawmember comprises a second symmetrical pattern of protrusions, andwherein the first symmetrical pattern of protrusions and the secondsymmetrical pattern of protrusions are complementary.

Example 8

The surgical end effector of Examples 1, 2, 3, 4, 5, or 6, wherein thefirst feature of the first jaw member comprises a first symmetricalpattern of protrusions, wherein the first feature of the second jawmember comprises a second symmetrical pattern of protrusions, andwherein the first symmetrical pattern of protrusions is different thanthe second symmetrical pattern of protrusions.

Example 9

The surgical end effector of Examples 1, 2, 3, 4, 5, or 6, wherein thefirst feature of the first jaw member comprises a first asymmetricalpattern of protrusions, wherein the first feature of the second jawmember comprises a second asymmetrical pattern of protrusions, andwherein the first asymmetrical pattern of protrusions and the secondasymmetrical pattern of protrusions are complementary.

Example 10

The surgical end effector of Examples 1, 2, 3, 4, 5, or 6, wherein thefirst feature of the first jaw member comprises a first asymmetricalpattern of protrusions, wherein the first feature of the second jawmember comprises a second asymmetrical pattern of protrusions, andwherein the first asymmetrical pattern of protrusions is different thanthe second asymmetrical pattern of protrusions.

Example 11

The surgical end effector of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10,wherein the first portion of the first jaw member is proximal to thesecond portion of the first jaw member.

Example 12

The surgical end effector of Examples 1, 2, 3, 4, 5, 6, or 11, whereinthe first feature of the first jaw member comprises a plurality ofprotrusions.

Example 13

The surgical end effector of Examples 1, 2, 3, 4, 5, 6, 11, or 12,wherein the second feature of the first jaw member comprises a pluralityof protrusions.

Example 14

The surgical end effector of Examples 1, 2, 3, 4, 5, 6, 11, 12, or 13,wherein the first feature of the first jaw member comprises a pluralityof protrusions, and wherein the second feature of the first jaw membercomprises a substantially smooth surface.

Example 15

The surgical end effector of Examples 1 or 2, wherein the first jawmember comprises an inside surface and an outside surface, and whereinthe first portion of the first jaw member is positioned along the insidesurface of the first jaw member, and wherein the second portion of thefirst jaw member is positioned along the outside surface of the firstjaw member.

Example 16

The surgical end effector of Examples 1, 2, or 15, wherein the firstfeature of the first jaw member comprises a plurality of protrusions,and wherein the second feature of the first jaw member comprises asubstantially smooth surface.

Example 17

The surgical end effector of Examples 1, 2, or 15, wherein the firstfeature of the first jaw member comprises a substantially smoothsurface, and wherein the second feature of the first jaw membercomprises a plurality of protrusions.

Example 18

The surgical end effector of Examples 1, 2, or 15, wherein the firstfeature of the first jaw member comprises a plurality of firstprotrusions, and wherein the second feature of the first jaw membercomprises a plurality of second protrusions.

Example 19

The surgical end effector of Example 18, wherein the plurality of firstprotrusions is different than the plurality of second protrusions.

Example 20

The surgical end effector of Examples 1, 2, or 15, wherein the firstfeature of the first jaw member comprises an asymmetrical profile, andwherein the second feature of the first jaw member comprises asymmetrical profile.

Example 21

The surgical end effector of Examples 1, 2, 15, or 20, wherein the firstfeature of the first jaw member comprises a low durometer surface.

Example 22

The surgical end effector of Examples 1, 2, 15, 20, or 21 wherein thesecond feature of the first jaw member comprises a low durometersurface.

Example 23

The surgical end effector of Examples 1, 2, or 15, wherein the firstfeature of the first jaw member comprises a curved profile.

Example 24

The surgical end effector of Examples 1, 2, or 15, wherein the secondfeature of the first jaw member comprises a curved profile.

Example 25

The surgical end effector of Examples 1, 2, 15, 16, 17, 18, 19, 20, 21,22, 23, or 24, wherein the first feature of the first jaw membercomprises a metallic material.

Example 26

The surgical end effector of Examples 1, 2, 15, 16, 17, 18, 19, 20, 21,22, 23, 24, or 25, wherein the second feature of the first jaw membercomprises a metallic material.

Example 27

A surgical end effector for use with a surgical instrument. The surgicalend effector comprises a proximal connector configured to attach to adistal end of the surgical instrument. The proximal connector comprisesan actuator. The surgical end effector further comprises a first jawmember. The first jaw member comprises a first portion comprising afirst feature, and a second portion comprising a second feature. Thesurgical end effector further comprises a second jaw member. At leastone of the first jaw member and the second jaw member is movablerelative to the other one of the first jaw member and the second jawmember between an open configuration and a closed configuration. Thesecond jaw member comprises a first portion comprising a first feature,and a second portion comprising a second feature. The surgical endeffector further comprises means for selecting at least one of the firstfeature of the first jaw member and the first feature of the second jawmember by a user.

Example 28

The surgical end effector of Example 27, wherein the means comprises anadditive manufacturing process.

Example 29

The surgical end effector of Examples 27 or 28, wherein the first jawmember comprises an inner surface and an outer surface, wherein thesecond jaw member comprises an inner surface and an outer surface, andwherein the inner surface of the first jaw member and the inner surfaceof the second jaw member comprise a mating relationship when thesurgical end effector is in the closed configuration.

Example 30

The surgical end effector of Examples 27, 28, or 29, wherein the firstfeature of the first jaw member comprises a tooth, wherein the firstfeature of the second jaw member comprises a void, and wherein, when thesurgical end effector is in the closed configuration, the tooth isreceived in the void.

Example 31

The surgical end effector of Examples 27, 28, 29, or 30, wherein thefirst feature of the first jaw member comprises a first material,wherein the second feature of the first jaw member comprises a secondmaterial, and wherein the first material is different than the secondmaterial.

Example 32

The surgical end effector of Examples 27, 28, 29, or 30, wherein thefirst feature of the first jaw member comprises a first material,wherein the first feature of the second jaw member comprises a secondmaterial, and wherein the first material is different than the secondmaterial.

Example 33

The surgical end effector of Examples 27, 28, 29, 30, 31, or 32, whereinthe first feature of the first jaw member comprises a first symmetricalpattern of protrusions, wherein the first feature of the second jawmember comprises a second symmetrical pattern of protrusions, andwherein the first symmetrical pattern of protrusions and the secondsymmetrical pattern of protrusions are complementary.

Example 34

The surgical end effector of Examples 27, 28, 29, 30, 31, or 32, whereinthe first feature of the first jaw member comprises a first symmetricalpattern of protrusions, wherein the first feature of the second jawmember comprises a second symmetrical pattern of protrusions, andwherein the first symmetrical pattern of protrusions is different thanthe second symmetrical pattern of protrusions.

Example 35

The surgical end effector of Examples 27, 28, 29, 30, 31, or 32, whereinthe first feature of the first jaw member comprises a first asymmetricalpattern of protrusions, wherein the first feature of the second jawmember comprises a second asymmetrical pattern of protrusions, andwherein the first asymmetrical pattern of protrusions and the secondasymmetrical pattern of protrusions are complementary.

Example 36

The surgical end effector of Examples 27, 28, 29, 30, 31, or 32, whereinthe first feature of the first jaw member comprises a first asymmetricalpattern of protrusions, wherein the first feature of the second jawmember comprises a second asymmetrical pattern of protrusions, andwherein the first asymmetrical pattern of protrusions is different thanthe second asymmetrical pattern of protrusions.

Example 37

The surgical end effector of Examples 27, 28, 29, 30, 31, 32, 33, 34,35, or 36, wherein the first portion of the first jaw member is proximalto the second portion of the first jaw member.

Example 38

The surgical end effector of Examples 27, 28, 29, 30, 31, 32, or 37,wherein the first feature of the first jaw member comprises a pluralityof protrusion.

Example 39

The surgical end effector of Examples 27, 28, 29, 30, 31, 32, 37, or 38,wherein the second feature of the first jaw member comprises a pluralityof protrusions.

Example 40

The surgical end effector of Examples 27, 28, 29, 30, 31, 32, 37, 38, or39, wherein the first feature of the first jaw member comprises aplurality of protrusions, and wherein the second feature of the firstjaw member comprises a substantially smooth surface.

Example 41

The surgical end effector of Examples 27 or 28, wherein the first jawmember comprises an inside surface and an outside surface, and where thefirst portion of the first jaw member is positioned along the insidesurface of the first jaw member, and wherein the second portion of thefirst jaw member is positioned along the outside surface of the firstjaw member.

Example 42

The surgical end effector of Examples 27, 28, or 41, wherein the firstfeature of the first jaw member comprises a plurality of protrusions,and wherein the second feature of the first jaw member comprises asubstantially smooth surface.

Example 43

The surgical end effector of Examples 27, 28, or 41, wherein the firstfeature of the first jaw member comprises a substantially smoothsurface, and wherein the second feature of the first jaw membercomprises a plurality of protrusions.

Example 44

The surgical end effector of Examples 27, 28, or 43, wherein the firstfeature of the first jaw member comprises a plurality of firstprotrusions, and wherein the second feature of the first jaw membercomprises a plurality of second protrusions.

Example 45

The surgical end effector of Example 44, wherein the plurality of firstprotrusions is different than the plurality of second protrusions.

Example 46

The surgical end effector of Examples 27, 28, or 41, wherein the firstfeature of the first jaw member comprises an asymmetrical profile, andwherein the second feature of the first jaw member comprises asymmetrical profile.

Example 47

The surgical end effector of Examples 27, 28, 41, or 46, wherein thefirst feature of the first jaw member comprises a low durometer surface.

Example 48

The surgical end effector of Examples 27, 28, 41, 46, or 47, wherein thesecond feature of the first jaw member comprises a low durometersurface.

Example 49

The surgical end effector of Examples 27, 28, or 41, wherein the firstfeature of the first jaw member comprises a curved profile.

Example 50

The surgical end effector of Examples 27, 28, or 41, wherein the secondfeature of the first jaw member comprises a curved profile.

Example 51

The surgical end effector of Examples 27, 28, 41, 42, 43, 44, 45, 46,47, 48, 49, or 50, wherein the first feature of the first jaw membercomprises a metallic material.

Example 52

The surgical end effector of Examples 27, 28, 41, 42, 43, 44, 45, 46,47, 48, 49, 50, or 51 wherein the second feature of the first jaw membercomprises a metallic material.

Example 53

A method for producing a customized end effector. The method comprisespreparing an end effector connector for customization. The end effectorconnector comprises a proximal connector configured to attach to adistal end of a surgical instrument. The proximal connector comprises anactuator. The method further comprises determining through interactionwith a patient a first desired characteristic of the end effector,determining through interaction with a patient a second desiredcharacteristic of the end effector, and creating a first jaw memberhaving the first desired characteristic. The first jaw member isattached to a distal portion of the end effector. The method furthercomprises creating a second jaw member having the second desiredcharacteristic. The second jaw member is attached to a distal portion ofthe end effector.

Example 54

The method of Example 53, further comprising producing the first jawmember and the second jaw member using an additive manufacturingprocess.

Example 55

The method of Example 54, wherein the additive manufacturing processcomprises 3-D printing.

Example 56

The method of Examples 53, 54, or 55, wherein the first characteristicof the first jaw member comprises a tooth, wherein the secondcharacteristic of the second jaw member comprises a void.

Example 57

The method of Examples 53, 54, 55, or 56, wherein the firstcharacteristic comprises a first material, wherein the secondcharacteristic comprises a second material, and wherein the firstmaterial is different than the second material.

Example 58

The method of Examples 53, 54, 55, 56, or 57, wherein the firstcharacteristic comprises a first symmetrical pattern of protrusions,wherein the second characteristic comprises a second symmetrical patternof protrusions, and wherein the first symmetrical pattern of protrusionsand the second symmetrical pattern of protrusions are complementary.

Example 59

The method of Examples 53, 54, 55, 56, or 57, wherein the firstcharacteristic comprises a first symmetrical pattern of protrusions,wherein the second characteristic comprises a second symmetrical patternof protrusions, and wherein the first symmetrical pattern of protrusionsis different than the second symmetrical pattern of protrusions.

Example 60

The method of Examples 53, 54, 55, 56, or 57, wherein the firstcharacteristic comprises a first asymmetrical pattern of protrusions,wherein the second characteristic comprises a second asymmetricalpattern of protrusions, and wherein the first asymmetrical pattern ofprotrusions and the second asymmetrical pattern of protrusions arecomplementary.

Example 61

The method of Examples 53, 54, 55, 56, or 57, wherein the firstcharacteristic comprises a first asymmetrical pattern of protrusions,wherein the second characteristic comprises a second asymmetricalpattern of protrusions, and wherein the first asymmetrical pattern ofprotrusions is different than the second asymmetrical pattern ofprotrusions.

Example 62

The method of Example 53, further comprising creating a third desiredcharacteristic on the first jaw member, and creating a fourth desiredcharacteristic on the second jaw member.

Example 63

The method of Example 62, wherein the first characteristic comprises aplurality of protrusions.

Example 64

The method of Examples 62 or 63, wherein the third characteristiccomprises a plurality of protrusions.

Example 65

The method of Examples 62 or 64, wherein the first characteristiccomprises a plurality of protrusions, and wherein the thirdcharacteristic comprises a substantially smooth surface.

Example 66

The method of Examples 62, 63, 64, or 65, wherein the first jaw membercomprises an inside surface and an outside surface, and where the firstcharacteristic is positioned along the inside surface of the first jawmember, and wherein the third characteristic is positioned along theoutside surface of the first jaw member.

Example 67

The method of Examples 62, 63, 64, 65, or 66, wherein the firstcharacteristic comprises a plurality of protrusions, and wherein thethird characteristic comprises a substantially smooth surface.

Example 68

The method of Examples 62, 63, 64, 65, or 66, wherein the firstcharacteristic comprises a substantially smooth surface, and wherein thethird characteristic comprises a plurality of protrusions.

Example 69

The method of Examples 62, 63, 64, 65, or 66, wherein the firstcharacteristic comprises a plurality of first protrusions, and whereinthe third characteristic comprises a plurality of second protrusions.

Example 70

The method of Example 69, wherein the plurality of first protrusions isdifferent than the plurality of second protrusions.

Example 71

The method of Examples 62, 63, 64, 65, or 66, wherein the firstcharacteristic comprises an asymmetrical profile, and wherein the thirdcharacteristic comprises a symmetrical profile.

Example 72

The method of Examples 62, 63, 64, 65, or 66, wherein the firstcharacteristic comprises a low durometer surface.

Example 73

The method of Examples 62, 63, 64, 65, or 66, wherein the thirdcharacteristic comprises a low durometer surface.

Example 74

The method of Examples 62, 63, 64, 65, or 66, wherein the firstcharacteristic comprises a curved profile.

Example 75

The method of Examples 62, 63, 64, 65, or 66, wherein the thirdcharacteristic comprises a curved profile.

Example 76

The method of Examples 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73,74, or 75, wherein the first characteristic comprises a metallicmaterial.

Example 77

The method of Examples 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73,74, 75, or 76, wherein the third characteristic comprises a metallicmaterial.

Example 78

A surgical instrument comprising a composite dissector jaw. Thecomposite dissector jaw comprises a first jaw. The first jaw comprises aproximal portion, a distal portion, a tissue contacting surface, ametallic core, and at least one layer of molded plastic on the metalliccore. The at least one layer of molded plastic defines a pattern. Thepattern defines at least a portion of the tissue contacting surface. Thetissue contacting surface further comprises at least a portion of themetallic core. The composite dissector jaw further comprises a secondjaw. At least one of the first jaw and the second jaw is rotatable withrespect to the other one of the first jaw and the second jaw.

Example 79

The surgical instrument of Example 78, wherein the pattern comprises afirst pattern on the proximal portion and a second pattern on the distalportion.

Example 80

The surgical instrument of Example 79, wherein the first pattern isdifferent than the second pattern.

Example 81

The surgical instrument of Examples 79 or 80, wherein the first patterncomprises a first thickness of the at least one layer of molded plastic,wherein the second pattern comprises a second thickness of the at leastone layer of molded plastic, and wherein the first thickness isdifferent than the second thickness.

Example 82

The surgical instrument of Example 81, wherein the first thickness isgreater than the second thickness.

Example 83

The surgical instrument of Example 81, wherein the first thickness isless than the second thickness.

Example 84

The surgical instrument of Examples 78, 79, 80, 81, 82, or 83, whereinthe at least one layer of molded plastic comprises a first layer and asecond layer.

Example 85

The surgical instrument of Example 84, wherein the first layer isdifferent than the second layer.

Example 86

The surgical instrument of Examples 84 or 85, wherein the first layercomprises a first material, wherein the second layer comprises a secondmaterial, and wherein the first material is different than the secondmaterial.

Example 87

The surgical instrument of Examples 84, 85, or 86, wherein the firstlayer is in contact with the metallic core, and wherein the second layeris in contact with the first layer.

Example 88

The surgical instrument of Examples 84, 85, or 86, wherein the firstlayer is positioned on the proximal portion, and wherein the secondlayer is positioned on the distal portion.

Example 89

The surgical instrument of Examples 84, 85, 86, 87, or 88, wherein thefirst layer comprises a first rigidity, wherein the second layercomprises a second rigidity, wherein the first rigidity is differentthan the second rigidity.

Example 90

The surgical instrument of Example 89, wherein the first rigidity isgreater than the second rigidity.

Example 91

The surgical instrument of Example 89, wherein the first rigidity isless than the second rigidity.

Example 92

The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86,87, 88, 89, 90, or 91, wherein the first pattern comprises a pluralityof recesses.

Example 93

The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86,87, 88, 89, 90, 91, or 92, wherein the first pattern comprises aplurality of ridges.

Example 94

The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86,87, 88, 89, 90, 91, 92, or 93, wherein the first pattern is symmetrical.

Example 95

The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86,87, 88, 89, 90, 91, 92, or 93, wherein the first pattern isasymmetrical.

Example 96

The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86,87, 88, 89, 90, 91, 92, 93, 94, or 95, wherein the at least one layer ofmolded plastic on the metallic core comprises openings, and wherein themetallic core is exposed to tissue via the openings.

Example 97

The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86,87, 88, 89, 90, 91, 92, 93, 94, 95, or 96, wherein the first jaw and thesecond jaw are mechanically driven open to create an ostomy.

Example 98

A surgical dissector comprising a first jaw member. The first jaw membercomprises a proximal end, a distal end, a first tissue contactingsurface, a second tissue contacting surface, a metallic core, and anonmetallic layer. The metallic core of the first jaw member isconfigured to transmit electrosurgical energy. The nonmetallic layer isdisposed over at least a portion of the metallic core of the first jawmember. The surgical dissector further comprises a second jaw member.The second jaw member comprises a proximal end, a distal end, a firsttissue contacting surface, a second tissue contacting surface, ametallic core, and a nonmetallic layer. The metallic core of the secondjaw member is configured to transmit electrosurgical energy. Thenonmetallic layer is disposed over at least a portion of the metalliccore of the second jaw member. The surgical dissector further comprisesa joint. The first jaw member and the second jaw member are rotatableabout the joint between closed and open positions.

Example 99

The surgical dissector of Example 98, wherein the first tissuecontacting surface of the first jaw member is positioned adjacent thefirst tissue contacting surface of the second jaw member when the firstand the second jaw members are in the closed position.

Example 100

The surgical dissector of Examples 98 or 99, wherein the first tissuecontacting surface of the first jaw member comprises a first pattern,and wherein the first tissue contacting surface of the second jaw membercomprises a second pattern, and wherein the first pattern is differentthan the second pattern.

Example 101

The surgical dissector of Examples 98 or 99, wherein the first tissuecontacting surface of the first jaw member comprises a first pattern,and wherein the first tissue contacting surface of the second jaw membercomprises a second pattern, and wherein the first pattern iscomplementary to the second pattern.

Example 102

The surgical dissector of Examples 98 or 99, wherein the first tissuecontacting surface of the first jaw member comprises a first pattern,and wherein the first tissue contacting surface of the second jaw membercomprises a second pattern, wherein the first pattern comprises aplurality of first teeth, and wherein the second pattern comprises aplurality of second teeth.

Example 103

The surgical dissector of Examples 98 or 99, wherein the first tissuecontacting surface of the first jaw member comprises a first pattern,and wherein the first tissue contacting surface of the second jaw membercomprises a second pattern, wherein the first pattern comprises aplurality of first recesses, and wherein the second pattern comprises aplurality of second recesses.

Example 104

The surgical dissector of Examples 98, 99, 100, 101, 102, or 103,wherein the nonmetallic layer of the first jaw member comprises a firstnonmetallic layer and a second nonmetallic layer.

Example 105

The surgical dissector of Example 104, wherein the first nonmetalliclayer is different than the second nonmetallic layer.

Example 106

The surgical dissector of Examples 104 or 105, wherein the firstnonmetallic layer comprises a first rigidity, wherein the secondnonmetallic layer comprises a second rigidity, and wherein the firstrigidity is different than the second rigidity.

Example 107

The surgical dissector of Example 98, wherein the first tissuecontacting surface of the first jaw member comprises a first pattern,wherein the second tissue contacting surface of the first jaw membercomprises a second pattern, and wherein the first pattern is differentthan the second pattern.

Example 108

The surgical dissector of Example 107, wherein the first patterncomprises a symmetrical pattern, and wherein the second patterncomprises an asymmetrical pattern.

Example 109

The surgical dissector of Examples 107 or 108, wherein the first patterncomprises a plurality of teeth, and wherein the second pattern comprisesa plurality of cavities.

Example 110

The surgical dissector of Examples 107 or 108, wherein the first patterncomprises a plurality of first cavities, wherein the second patterncomprises a plurality of second cavities.

Example 111

The surgical dissector of Example 110, wherein the plurality of firstcavities comprises a first depth, wherein the plurality of secondcavities comprises a second depth, and wherein the first depth isdifferent than the second depth.

Example 112

A surgical instrument comprising a jaw. The jaw comprises a metalliccore and an outer skin. The outer skin comprises a plurality of firstthrough holes exposing the metallic core to an outer surface of the jaw.The plurality of first through holes comprise a first through hole size.The outer skin further comprises a plurality of second through holesexposing the metallic core to the outer surface of the jaw. Theplurality of second through holes comprise a second through hole size.The first through hole size is different than the second through holesize.

Example 113

The surgical instrument of Example 112, wherein the jaw furthercomprises a first region. The plurality of first through holes arepositioned within the first region. The jaw further comprises a secondregion. The plurality of second through holes are positioned within thesecond region. The first region is different than the second region.

Example 114

The surgical instrument of Examples 112 or 113, wherein the jawcomprises a tip region, wherein the first through hole size is smallerthan the second through hole size, and wherein the plurality of firstthrough holes are positioned within the tip region.

Example 115

The surgical instrument of Examples 112 or 113, wherein the jawcomprises a tip region, wherein the first through hole size is largerthan the second through hole size, and wherein the plurality of firstthrough holes are positioned within the tip region.

Example 116

The surgical instrument of Examples 112, 113, 114, or 115, wherein theplurality of first through holes and the plurality of second throughholes are intermixed along the outer skin.

Example 117

The surgical instrument of Examples 112, 113, 114, 115, or 116, whereinthe plurality of first through holes are round, and wherein theplurality of second through holes are round.

Example 118

The surgical instrument of Examples 112, 113, 114, 115, or 116, whereinthe plurality of first through holes are round, and wherein theplurality of second through holes are non-round.

Example 119

The surgical instrument of Examples 112, 113, 114, 115, or 116, whereinthe plurality of first through holes are non-round, and wherein theplurality of second through holes are non-round.

Example 120

The surgical instrument of Examples 112, 113, 114, 115, 116, 117, 118,or 119, wherein the outer skin comprises an insulative plastic.

Example 121

The surgical instrument of Examples 112, 113, 114, 115, 116, 117, 118,or 119, wherein the outer skin comprises a semi-conductive plastic.

Example 122

The surgical instrument of Examples 112, 113, 114, 115, 116, 117, 118,or 119, wherein the outer skin is semi-conductive.

Example 123

The surgical instrument of Examples 112, 113, 114, 115, 116, 117, 118,or 119, wherein the outer skin comprises intrinsically conductingpolymers.

Example 124

A surgical dissector comprising a first jaw member. The first jaw membercomprises a first tissue contacting surface. The first tissue contactingsurface comprises a first electrically conductive portion and a firstelectrically insulative portion. The surgical dissector furthercomprises a second jaw member. The second jaw member comprises a secondtissue contacting surface. The second tissue contacting surfacecomprises a second electrically conductive portion and a secondelectrically insulative portion. The surgical dissector furthercomprises a pivot. The first jaw member and the second jaw member arerotatable about the pivot. The surgical dissector further comprisesmeans for separating tissue. The means for separating tissue comprisesmeans for applying a mechanical force to tissue of a patient throughrotation of at least one of the first jaw member and the second jawmember, and means for applying electrosurgical force to the tissuethrough at least one of the first electrically conductive portion andthe second electrically conductive portion.

Example 125

The surgical dissector of Example 124, wherein the means for separatingtissue comprises applying the mechanical force in an amount less thanthe separation pressure needed to separate the tissue and applyingelectrosurgical force which supplements the mechanical force to separatethe tissue.

The devices, systems, and methods disclosed in the Subject applicationcan be used with the devices, systems, and methods disclosed in U.S.Provisional Patent Application No. 62/659,900, entitled METHOD OF HUBCOMMUNICATION, filed on Apr. 19, 2018, U.S. Provisional PatentApplication No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM,filed on Dec. 28, 2017, U.S. Provisional Patent Application No.62/611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on Dec. 28,2017, and U.S. Provisional Patent Application No. 62/611,339, entitledROBOT ASSISTED SURGICAL PLATFORM, filed on Dec. 28, 2017, which areincorporated in their entireties herein. The devices, systems, andmethods disclosed in the Subject application can also be used with thedevices, systems, and methods disclosed in U.S. patent application Ser.No. 15/908,021, entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE, filedon Feb. 28, 2018, U.S. patent application Ser. No. 15/908,012, entitledSURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENTTYPES OF END EFFECTOR MOVEMENT, filed on Feb. 28, 2018, U.S. patentapplication Ser. No. 15/908,040, entitled SURGICAL INSTRUMENT WITHROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS,filed on Feb. 28, 2018, U.S. patent application Ser. No. 15/908,057,entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATINGMULTIPLE END EFFECTOR FUNCTIONS, filed on Feb. 28, 2018, U.S. patentapplication Ser. No. 15/908,058, entitled SURGICAL INSTRUMENT WITHMODULAR POWER SOURCES, filed on Feb. 28, 2018, and U.S. patentapplication Ser. No. 15/908,143, entitled SURGICAL INSTRUMENT WITHSENSOR AND/OR CONTROL SYSTEMS, filed on Feb. 28, 2018, which areincorporated in their entireties herein. The devices, systems, andmethods disclosed in the Subject application can also be used with thedevices, systems, and methods disclosed in U.S. patent application Ser.No. 14/226,133, now U.S. Patent Application Publication No.2015/0272557, entitled MODULAR SURGICAL INSTRUMENT SYSTEM, filed on Mar.26, 2014, which is incorporated in its entirety herein.

The entire disclosures of:

-   -   U.S. patent application Ser. No. 11/013,924, entitled TROCAR        SEAL ASSEMBLY, now U.S. Pat. No. 7,371,227;    -   U.S. patent application Ser. No. 11/162,991, entitled        ELECTROACTIVE POLYMER-BASED ARTICULATION MECHANISM FOR GRASPER,        now U.S. Pat. No. 7,862,579;    -   U.S. patent application Ser. No. 12/364,256, entitled SURGICAL        DISSECTOR, now U.S. Patent Application Publication No.        2010/0198248;    -   U.S. patent application Ser. No. 13/536,386, entitled EMPTY CLIP        CARTRIDGE LOCKOUT, now U.S. Pat. No. 9,282,974;    -   U.S. patent application Ser. No. 13/832,786, entitled CIRCULAR        NEEDLE APPLIER WITH OFFSET NEEDLE AND CARRIER TRACKS, now U.S.        Pat. No. 9,398,905;    -   U.S. patent application Ser. No. 12/592,174, entitled APPARATUS        AND METHOD FOR MINIMALLY INVASIVE SUTURING, now U.S. Pat. No.        8,123,764;    -   U.S. patent application Ser. No. 12/482,049, entitled ENDOSCOPIC        STITCHING DEVICES, now U.S. Pat. No. 8,628,545;    -   U.S. patent application Ser. No. 13/118,241, entitled SURGICAL        STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT        ARRANGEMENTS, now U.S. Pat. No. 9,072,535;    -   U.S. patent application Ser. No. 11/343,803, entitled SURGICAL        INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No.        7,845,537;    -   U.S. patent application Ser. No. 14/200,111, entitled CONTROL        SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,629;    -   U.S. patent application Ser. No. 14/248,590, entitled MOTOR        DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, now        U.S. Pat. No. 9,826,976;    -   U.S. patent application Ser. No. 14/813,242, entitled SURGICAL        INSTRUMENT COMPRISING SYSTEMS FOR ASSURING THE PROPER SEQUENTIAL        OPERATION OF THE SURGICAL INSTRUMENT, now U.S. Patent        Application Publication No. 2017/0027571;    -   U.S. patent application Ser. No. 14/248,587, entitled POWERED        SURGICAL STAPLER, now U.S. Pat. No. 9,867,612;    -   U.S. patent application Ser. No. 12/945,748, entitled SURGICAL        TOOL WITH A TWO DEGREE OF FREEDOM WRIST, now U.S. Pat. No.        8,852,174;    -   U.S. patent application Ser. No. 13/297,158, entitled METHOD FOR        PASSIVELY DECOUPLING TORQUE APPLIED BY A REMOTE ACTUATOR INTO AN        INDEPENDENTLY ROTATING MEMBER, now U.S. Pat. No. 9,095,362;    -   International Application No. PCT/US2015/023636, entitled        SURGICAL INSTRUMENT WITH SHIFTABLE TRANSMISSION, now        International Patent Publication No. WO 2015/153642 A1;    -   International Application No. PCT/US2015/051837, entitled        HANDHELD ELECTROMECHANICAL SURGICAL SYSTEM, now International        Patent Publication No. WO 2016/057225 A1;    -   U.S. patent application Ser. No. 14/657,876, entitled SURGICAL        GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES, U.S.        Patent Application Publication No. 2015/0182277;    -   U.S. patent application Ser. No. 15/382,515, entitled MODULAR        BATTERY POWERED HANDHELD SURGICAL INSTRUMENT AND METHODS        THEREFOR, U.S. Patent Application Publication No. 2017/0202605;    -   U.S. patent application Ser. No. 14/683,358, entitled SURGICAL        GENERATOR SYSTEMS AND RELATED METHODS, U.S. Patent Application        Publication No. 2016/0296271;    -   U.S. patent application Ser. No. 14/149,294, entitled HARVESTING        ENERGY FROM A SURGICAL GENERATOR, U.S. Pat. No. 9,795,436;    -   U.S. patent application Ser. No. 15/265,293, entitled TECHNIQUES        FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, U.S. Patent        Application Publication No. 2017/0086910; and    -   U.S. patent application Ser. No. 15/265,279, entitled TECHNIQUES        FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL        SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, U.S. Patent        Application Publication No. 2017/0086914, are hereby        incorporated by reference herein.

Although various devices have been described herein in connection withcertain embodiments, modifications and variations to those embodimentsmay be implemented. Particular features, structures, or characteristicsmay be combined in any suitable manner in one or more embodiments. Thus,the particular features, structures, or characteristics illustrated ordescribed in connection with one embodiment may be combined in whole orin part, with the features, structures or characteristics of one oremore other embodiments without limitation. Also, where materials aredisclosed for certain components, other materials may be used.Furthermore, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Theforegoing description and following claims are intended to cover allsuch modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, a device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the stepsincluding, but not limited to, the disassembly of the device, followedby cleaning or replacement of particular pieces of the device, andsubsequent reassembly of the device. In particular, a reconditioningfacility and/or surgical team can disassemble a device and, aftercleaning and/or replacing particular parts of the device, the device canbe reassembled for subsequent use. Those skilled in the art willappreciate that reconditioning of a device can utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

The devices disclosed herein may be processed before surgery. First, anew or used instrument may be obtained and, when necessary, cleaned. Theinstrument may then be sterilized. In one sterilization technique, theinstrument is placed in a closed and sealed container, such as a plasticor TYVEK bag. The container and instrument may then be placed in a fieldof radiation that can penetrate the container, such as gamma radiation,x-rays, and/or high-energy electrons. The radiation may kill bacteria onthe instrument and in the container. The sterilized instrument may thenbe stored in the sterile container. The sealed container may keep theinstrument sterile until it is opened in a medical facility. A devicemay also be sterilized using any other technique known in the art,including but not limited to beta radiation, gamma radiation, ethyleneoxide, plasma peroxide, and/or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdo not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

What is claimed is:
 1. A surgical end effector for use with a surgicalinstrument, comprising: a proximal connector configured to attach to adistal end of the surgical instrument, wherein said proximal connectorcomprises an actuator; a first jaw member, comprising: a first portioncomprising a first feature; and a second portion comprising a secondfeature; and a second jaw member, wherein at least one of said first jawmember and said second jaw member is independently movable relative tosaid other one of said first jaw member and said second jaw member abouta joint between an open configuration and a closed configuration, andwherein said second jaw member comprises: a first portion comprising afirst feature; and a second portion comprising a second feature; whereinat least one of said first feature of said first jaw member and saidfirst feature of said second jaw member is selected by a user in anadditive manufacturing process.
 2. The surgical end effector of claim 1,wherein said additive manufacturing process comprises 3-D printing. 3.The surgical end effector of claim 1, wherein said first jaw membercomprises an inner surface and an outer surface, wherein said second jawmember comprises an inner surface and an outer surface, and wherein saidinner surface of said first jaw member and said inner surface of saidsecond jaw member comprise a mating relationship when said surgical endeffector is in said closed configuration.
 4. The surgical end effectorof claim 3, wherein said first feature of said first jaw membercomprises a tooth, wherein said first feature of said second jaw membercomprises a void, and wherein, when said surgical end effector is insaid closed configuration, said tooth is received in said void.
 5. Thesurgical end effector of claim 1, wherein said first feature of saidfirst jaw member comprises a first material, wherein said second featureof said first jaw member comprises a second material, and wherein saidfirst material is different than said second material.
 6. The surgicalend effector of claim 1, wherein said first feature of said first jawmember comprises a first material, wherein said first feature of saidsecond jaw member comprises a second material, and wherein said firstmaterial is different than said second material.
 7. The surgical endeffector of claim 1, wherein said first feature of said first jaw membercomprises a first symmetrical pattern of protrusions, wherein said firstfeature of said second jaw member comprises a second symmetrical patternof protrusions, and wherein said first symmetrical pattern ofprotrusions and said second symmetrical pattern of protrusions arecomplementary.
 8. The surgical end effector of claim 1, wherein saidfirst feature of said first jaw member comprises a first symmetricalpattern of protrusions, wherein said first feature of said second jawmember comprises a second symmetrical pattern of protrusions, andwherein said first symmetrical pattern of protrusions is different thansaid second symmetrical pattern of protrusions.
 9. The surgical endeffector of claim 1, wherein said first feature of said first jaw membercomprises a first asymmetrical pattern of protrusions, wherein saidfirst feature of said second jaw member comprises a second asymmetricalpattern of protrusions, and wherein said first asymmetrical pattern ofprotrusions and said second asymmetrical pattern of protrusions arecomplementary.
 10. The surgical end effector of claim 1, wherein saidfirst feature of said first jaw member comprises a first asymmetricalpattern of protrusions, wherein said first feature of said second jawmember comprises a second asymmetrical pattern of protrusions, andwherein said first asymmetrical pattern of protrusions is different thansaid second asymmetrical pattern of protrusions.
 11. The surgical endeffector of claim 1, wherein said first portion of said first jaw memberis proximal to said second portion of said first jaw member.
 12. Thesurgical end effector of claim 11, wherein said first feature of saidfirst jaw member comprises a plurality of protrusions.
 13. The surgicalend effector of claim 11, wherein said second feature of said first jawmember comprises a plurality of protrusions.
 14. The surgical endeffector of claim 11, wherein said first feature of said first jawmember comprises a plurality of protrusions, and wherein said secondfeature of said first jaw member comprises a substantially smoothsurface.
 15. The surgical end effector of claim 1, wherein said firstjaw member comprises an inside surface and an outside surface, andwherein said first portion of said first jaw member is positioned alongsaid inside surface of said first jaw member, and wherein said secondportion of said first jaw member is positioned along said outsidesurface of said first jaw member.
 16. The surgical end effector of claim15, wherein said first feature of said first jaw member comprises aplurality of protrusions, and wherein said second feature of said firstjaw member comprises a substantially smooth surface.
 17. The surgicalend effector of claim 15, wherein said first feature of said first jawmember comprises a substantially smooth surface, and wherein said secondfeature of said first jaw member comprises a plurality of protrusions.18. The surgical end effector of claim 15, wherein said first feature ofsaid first jaw member comprises a plurality of first protrusions, andwherein said second feature of said first jaw member comprises aplurality of second protrusions.
 19. The surgical end effector of claim18, wherein said plurality of first protrusions is different than saidplurality of second protrusions.
 20. The surgical end effector of claim15, wherein said first feature of said first jaw member comprises anasymmetrical profile, and wherein said second feature of said first jawmember comprises a symmetrical profile.
 21. The surgical end effector ofclaim 15, wherein said first feature of said first jaw member comprisesa low durometer surface.
 22. The surgical end effector of claim 15,wherein said second feature of said first jaw member comprises a lowdurometer surface.
 23. The surgical end effector of claim 15, whereinsaid first feature of said first jaw member comprises a curved profile.24. The surgical end effector of claim 15, wherein said second featureof said first jaw member comprises a curved profile.
 25. The surgicalend effector of claim 15, wherein said first feature of said first jawmember comprises a metallic material.
 26. The surgical end effector ofclaim 15, wherein said second feature of said first jaw member comprisesa metallic material.
 27. A surgical end effector for use with a surgicalinstrument, comprising: a proximal connector configured to attach to adistal end of the surgical instrument, wherein said proximal connectorcomprises an actuator; a first jaw member, comprising: a first portioncomprising a first feature; and a second portion comprising a secondfeature; and a second jaw member, wherein at least one of said first jawmember and said second jaw member is independently movable relative tosaid other one of said first jaw member and said second jaw member abouta pivot between an open configuration and a closed configuration, andwherein said second jaw member comprises: a first portion comprising afirst feature; and a second portion comprising a second feature; andmeans for selecting at least one of said first feature of said first jawmember and said first feature of said second jaw member by a user.